Executive dysfunction in organic personality disorder: profile specifics and diagnostic significance

Context and relevance of the study stem from the insufficient understanding of the structure of executive function (EF) impairments in mental disorders, as well as the need to evaluate the effectiveness of a comprehensive EF analysis as a method for identifying objective neurocognitive markers during forensic psychiatric examinations. The primary hypothesis of the study was that the neuropsychological profile of EF impairments in organic personality disorder (OPD) differs from the profiles of EF impairments in other mental disorders. The aim of the study was to identify an invariant pattern of EF impairments in organic personality disorder (OPD) and its differentiating features relative to mentally healthy individuals, individuals with organic emotionally labile disorder (OELD), alcohol or drug dependence, and patients with schizophrenia. The study included 133 adult male defendants undergoing inpatient forensic psychiatric evaluation with verified diagnoses of OPD (n = 54), OELR (n = 11), alcohol (n = 14) or drug (n = 12) dependence, schizophrenia (n = 25), and mentally healthy individuals (n = 17). The results showed that OPD is characterized by a specific profile of EF impairments, where, against the background of a moderate general deficit, the most pronounced impairments are in the components of the functional working system (phonological loop, central executive) and in the area of inhibitory control. Significant differences were found between this profile and EF indicators in OELR, schizophrenia, drug dependence, and the norm group, while the impairment profile in alcohol dependence did not statistically differ from that in OPD. Conclusions. The existence of a specific neuropsychological profile of EF in OPD has been confirmed, which has differential diagnostic value and represents the basis for personalized expert assessment and the development of targeted rehabilitation programs.

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