BACKGROUND Medical personality change (MPC) is a codable diagnosis (i.e., F07.0) that deserves consideration when a patient is inexplicably no longer "acting like him/herself." Its presentation ranges from subtle to severe and is often characterized by bafflingly poor judgment and impairment in several aspects of a person's life. Despite the global impact that MPC can have on a patient's functioning, occupation, and relationships, this condition receives far less clinical consideration than better known syndromes such as depression or anxiety and is often likely incorrectly formulated as such. OBJECTIVE/METHODS This article provides a clinically focused review of MPC. We review its clinical assessment followed by a review of its subtypes, which we have categorized to reflect the behavioral correlates of known frontotemporal-subcortical circuits. These include the apathetic type (ventromedial prefrontal cortex), the labile and disinhibited types (orbitofrontal cortex), and the aggressive and paranoid types (medial temporal lobes). RESULTS For each of these 3 categories, we describe the clinical presentation and review management strategies. For each category, we focus on 3 common causes for MPC-traumatic brain injury, Huntington disease, and brain tumors-which we have selected because clinical features of MPC due to these conditions generalize to many other etiologies of MPC. CONCLUSIONS MPC warrants clinical attention for the range of dysfunction and distress it can cause. It also deserves further scientific study to better characterize its phenotypes, to tailor instruments for its clinical assessment, and to identify effective treatments.

中文翻译：

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由于另一种疾病引起的人格改变的临床方法

背景医学人格改变（MPC）是一种可编码的诊断（即F07.0），当患者莫名其妙地不再“表现得像他/她自己”时，值得考虑。它的表现从轻微到严重不等，并且通常以令人费解的判断力差和在一个人生活的多个方面受损为特征。尽管 MPC 可以对患者的功能、职业和人际关系产生全球性影响，但与抑郁或焦虑等众所周知的综合征相比，这种情况在临床上的考虑要少得多，而且经常被错误地表述为此类。目的/方法 本文提供了 MPC 的临床重点综述。我们审查其临床评估，然后审查其亚型，我们对其进行分类以反映已知额颞-皮层下回路的行为相关性。这些包括冷漠型（腹内侧前额叶皮层）、不稳定和解除抑制型（眶额叶皮层）以及攻击性和偏执型（内侧颞叶）。结果 对于这 3 个类别中的每一个，我们描述了临床表现和审查管理策略。对于每个类别，我们关注 MPC 创伤性脑损伤、亨廷顿病和脑肿瘤的 3 种常见原因，我们之所以选择这些原因，是因为这些病症引起的 MPC 的临床特征可推广到 MPC 的许多其他病因。结论 MPC 值得临床关注它可能引起的功能障碍和痛苦的范围。它还值得进一步科学研究以更好地表征其表型，