able onset and course.
The clinical presentation in a given individual may depend on the nature and localiza-
tion of the pathological process. For example, injury to the frontal lobes may yield symp-
toms such as lack of judgment or foresight, facetiousness, disinhibition, and euphoria.
Right hemisphere strokes have often been shown to evoke personal ity changes in asso-
ciation with unilateral spatial neglect, anos ognosia (i.e., inability of the individual to
recognize a bodily or functional deficit, such as the existence of hemiparesis), motor im-
persistence, and other ne urological deficits.
Associated Features Supporting Diagnosis
A variety of neurological and other medica l conditions may cause personality changes,
including central nervous system neoplasm s, head trauma, cerebrovascular disease,
Huntington’s disease, epilepsy, infectious conditions with central nervous system in-
volvement (e.g., HIV), endocrine conditions (e.g., hypothyroidism, hypo- and hyperadre-
nocorticism), and autoimmune conditions with central nerv ous system involvement (e.g.,
systemic lupus erythematosus). The associat ed physical examination findings, laboratory
findings, and patterns of preval ence and onset reflec t those of the neurological or other
medical condition involved.
Differential Diagnosis
Chronic medical conditions associ ated with pain and disability. Chronic medical con-
ditions associated with pain and disability can also be associated with changes in person-
ality. The diagnosis of personality change du e to another medical condition is given only
if a direct pathophysiological mechanism can be established. This diagnosis is not given if
the change is due to a behavioral or psycholo gical adjustment or response to another med-
ical condition (e.g., dependent behaviors that result from a need for the assistance of others