Mental disorders associated with nutritional and metabolic diseases
Introduction
Introduction to mental disorders associated with nutritional metabolic diseases Nutritional metabolic diseases associated with mental disorders mostly refer to neuropsychiatric disorders caused by vitamin or other nutrient deficiencies, metabolic disorders and insufficient energy supply. Vitamin B deficiency can lead to physical and mental disorders, metabolic disorders and insufficient energy supply, physical, neurological, and mental disorders. The lack of B1, B2, B5, B6, and B12 in vitamin B can cause neuropsychiatric disorders. When some vitamins are too much, such as vitamin A, vitamin D, vitamin B1, etc., neuropsychiatric symptoms may also occur. basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: epilepsy, dementia, neuritis, nystagmus
Cause
Causes of mental disorders associated with nutritional metabolic diseases
(1) Causes of the disease
Vitamin B1 deficiency (thiamine deficiency) is caused by digestive diseases, such as intestinal malabsorption, liver storage during liver disease, inadequate intake due to chronic alcohol dependence, and taking narcotics. People suffering from mental illness are also prone to vitamin B1 deficiency. The lack of mental symptoms caused by this disease may be related to metabolic disorders or accumulation of acetone, and other vitamins, proteins, fats, etc. are also important reasons.
Niacin deficiency, also known as pellagra or Pellagra, is caused by niacin, which is one of the important coenzymes for cellular metabolism in the body. Niacin and nicotinamide are combined. The formation of coenzyme I, II and other important components, such as niacin deficiency, brain niacin is lower than normal can lead to extensive degeneration of the brain, pituitary cells, basal ganglia, anterior horn cells of the spinal cord, etc., can cause increased catecholamine methylation, The neuropsychiatric symptoms are caused by consumptive diseases, hypothyroidism, adrenocorticotropic hormone and aldosterone deficiency, and the use of phenothiazines, oral contraceptives and alcohol, often accompanied by other vitamin deficiency. For example, vitamin B1, etc., it has also been suggested that the occurrence of neuropsychiatric symptoms at this time is related to the metabolism of tryptophan.
(two) pathogenesis
Vitamin B1 deficiency is associated with a variety of neuropsychiatric disorders. The severe typical neuropsychiatric syndrome it causes is beriberi (beriberi) and Wernicke encephalopathy. The pathological changes are mainly from the papillary body, hypothalamus, and midbrain aqueduct to the first In the fourth ventricle and cerebellar cortex, bilateral symmetry of perivascular endothelial cell hypertrophy, sporadic hemorrhage, etc., and mental retardation occur; if the network structure is involved, consciousness disorder occurs; when vitamin B1 deficiency is associated with glucose metabolism disorder, brain may appear. Edema, neurological symptoms are caused by congestion of the brain and spinal cord, edema, degeneration, etc. due to vitamin B1 deficiency. The above changes are most prominent in the peripheral nerves. The limb nerves, the phrenic nerve endings, the cranial nerves and the vagus nerve terminal branches are also more susceptible. Frequent peripheral neuritis, nystagmus, ocular dyskinesia, ataxia, occasional retinal hemorrhage, etc., are often rare.
Niacin deficiency accompanied by mental disorders, also known as pellagra or Pellagra disease, causes many causes of niacin deficiency, such as inadequate food intake, chronic alcoholism and long-term diarrhea, niacin deficiency can lead to cerebral cortex , white matter, pituitary cells, basal ganglia, and posterior and lateral bundle degeneration of the spinal cord cause mental disorders. Some people think that niacin is a polymethyl receptor, and its deficiency can lead to an increase in catecholamine methylation products. Mental disorder.
It has been reported in recent years that folic acid and vitamin B12 deficiency may play a leading role in some psychiatric diseases. The role of folic acid has been confirmed in depression and schizophrenia-like diseases. Folic acid deficiency may be associated with dementia in elderly patients with mental disorders.
Prevention
Prevention of mental disorders associated with nutritional metabolic diseases
Mainly for the prevention of primary diseases, it is generally believed that malnutrition is nutritional deficiencies. In fact, nutritional deficiencies and overnutrition are manifestations of malnutrition. In other words, people's thinness and obesity caused by uneven diet are malnourished. Undernutrition and overnutrition are not simple poverty or affluence issues. This is closely related to the education level of the people, the attitude towards health and the way they take healthy behavior. In the past 10 years, the dietary and nutritional status of urban and rural residents in China have been Significant improvement, but still facing the dual challenges of nutritional deficiencies and overnutrition diseases, hypertension, diabetes, hyperlipidemia, obesity has been considered a death quartet in today's society, and obesity is type II diabetes, high blood pressure, The source of metabolic diseases such as dyslipidemia is an independent risk factor for type 2 diabetes and cardiovascular disease. Obesity has been recognized as one of the four major social medical problems in the world. Throughout life, nutrition is life-sustaining. Basic substances, however, in the process of nutritional supplements, balanced nutrition can make the body Kang, therefore, rational and scientific supplementation of nutrition, treatment of disease has not been disease, is the guarantee of health, only to improve the way of life, to achieve a comprehensive and balanced nutrition, in order to constantly adjust the immune function, so that people can be from nutrition Obtaining health, thereby improving the quality of life, malnutrition directly affects health, and only eats reasonably to be healthy. Therefore, people only pay attention to the quantitative and balanced diet, exercise and exercise properly, insist on regular weight measurement, and maintain a peace of mind. Accompanied by health, with high quality of life.
In order to maintain normal physiological functions and meet the normal growth and development of the body, metabolism, work, and labor needs, humans must consume the necessary nutrients from food every day. The nutrients in these diets are called nutrients, mainly including proteins. There are seven categories of vitamins, minerals, lipids, sugars, water and cellulose. Reasonable nutrition means providing a sufficient amount of heat and various nutrients to the body through reasonable diet and scientific cooking. The balance between the numbers to meet the normal physiological needs of the human body, to maintain human health, many people think that eating well, very nutritious, in fact, is in a state of "hidden hunger", the body lacks the necessary trace elements, such as iron , vitamin A, iodine, zinc, etc., although eating a lot, but the health is not good, many adults suffer from long-term nutritional imbalances such as heart disease, stroke, gout, cancer and diabetes, due to individual differences The amount of nutrients required by each person at different times, at different ages, or between different genders and occupations Different from others, especially those with different diseases, the nutritional needs are different, so it is necessary to have a reasonable meal.
In short, a scientific and rational lifestyle, eating habits can help prevent the occurrence of this disease, a better personality, psychology will help to reduce the occurrence of mental symptoms after illness.
Complication
Mental disorders associated with nutritional metabolic diseases Complications, epilepsy, dementia, neuritis, nystagmus
Nutritional metabolic diseases can cause complications of various systemic systems such as follicular hyperkeratosis, flat dermatitis, periodontal disease, neck nodular goiter, hand, foot and ankle.
Complications of mental disorders include secondary epilepsy, dementia, and hemiplegia. A disturbance of consciousness can manifest itself as a state of paralysis. Neuritis, nystagmus, and disorder have occasional retinal hemorrhage.
Symptom
Symptoms of mental disorders associated with nutritional metabolic diseases Common symptoms Deficiency of tongue inflammation, diarrhea, cognitive ability, lack of retinal hemorrhage, coma, exfoliative dermatitis, uncoordinated excitability, somatic disease...
1. Vitamin B1 deficiency (thiamine deficiency) with psychiatric symptoms
(1) Mental disorders: depression; governance disorders; disturbances of consciousness can be expressed as paralyzed states, occasionally paralyzed states.
(2) neurological symptoms: neuritis, nystagmus, dysregulation, occasional retinal hemorrhage.
2. Niacin deficiency accompanied by mental disorders
(1) Mental disorders:
1 neurasthenic syndrome: often appear in the early stages of the disease or milder.
2 Depression state: often accompanied by irritability, anxiety, self-blame and self-crime, attempted suicide, etc., which occurs well in the disease process.
3 tension syndrome: tension or excitement or tension, similar to the nervous type of schizophrenia.
4 disturbance of consciousness: occur in patients with acute onset, patients with late stage of the disease may have confusion, lethargy, paralysis, or disordered state, can cause coma in severe cases, high mortality, called niacin deficiency encephalopathy, this Often with neurological symptoms and characteristics.
5 Chronic encephalopathy syndrome: patients with chronic phase may have unresponsiveness, memory, loss of computational power, slow and slow movements, and severe cases of Korsakov syndrome or dementia.
6 a small number can be manifested as encephalopathy: clinically, mainly with disturbance of consciousness, and with heavier neurological symptoms and signs.
(2) Neurological symptoms: nystagmus, pupillary changes (pupil enlargement, slow light reflex), positive pyramidal tract sign, increased muscle tone, paresthesia, peripheral neuritis and epileptic seizures, such as subacute spinal cord When combined with degeneration, deep sensory motor disorders and mutual dyskinesia can occur.
(3) physical symptoms: glossitis, strawberry tongue; exfoliative dermatitis; gastrointestinal dysfunction, with diarrhea, dermatitis most obvious, plus dementia is often called the three main signs of niacin deficiency.
Examine
Examination of mental disorders associated with nutritional metabolic diseases
Check the items in accordance with the actual situation of the patient.
Diagnosis
Diagnosis and diagnosis of mental disorders associated with nutritional metabolic diseases
1. There is evidence of disease-deficient disease, such as niacin, vitamin B1 and folate deficiency.
2. There are symptoms and signs of abnormal dysfunction caused by lack of nutrient metabolism.
3. Psychiatric symptoms change with the development of symptoms of nutritional metabolism deficiency, that is, mental symptoms appear after physical diseases, and developmental changes are parallel with physical diseases.
4. Relevant nutrition (nicotinic acid, vitamin B1 and folic acid, etc.) has significant therapeutic effects.
5. It should be differentiated from other functional declines associated with mental disorders and other functional psychosis such as schizophrenia, snoring and depression.
According to the lack of related nutrition (nicotinic acid, vitamin B1 and folic acid) and related symptoms and signs, it is not difficult to distinguish from other physical diseases with mental disorders, schizophrenia and depression.
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