F07 — Personality and behavioural disorders due to brain disease, damage and dysfunction

What is this category?

F07 groups presentations in which brain disease, damage, or dysfunction has produced an alteration of a person's previously characteristic pattern of behaviour, especially involving the expression of emotions, needs, and impulses. The person's cognition may be largely intact; what has changed is who they characteristically are in their behaviour and emotional expression.

Core diagnostic concept

The classification question F07 answers is not "has this person's cognition declined?" but "has brain disease or injury produced a genuine, sustained change from this person's own previous personality — in emotional expression, impulse control, social judgement, or motivation — that is distinguishable from how they were before?" A collateral account of the person's premorbid personality is essential to answering this.

Key diagnostic features

A change from previous characteristic personality

Altered expression of emotions, needs and impulses — for example, new emotional lability, disinhibition, apathy, or irritability — representing a genuine change, not a lifelong trait.

Reduced capacity for goal-directed activity

Difficulty sustaining purposeful activity or persevering with tasks, sometimes alongside marked apathy.

Altered social and sexual behaviour

Coarsened social judgement, disinhibited or altered sexual behaviour, or reduced regard for social convention, again as a change from baseline.

Cognitive disturbance, if present, is not the dominant feature

Mild cognitive changes can accompany F07, but the defining feature is the personality/behavioural change itself, not global cognitive decline.

A demonstrable brain disease, damage, or dysfunction

A recognised cause — for example, frontal lobe injury, encephalitis, or a chronic brain disease — with a plausible link to the personality change.

How to weigh evidence

These learning labels are teaching aids, not official ICD-10 terminology (see Sources and Method).

• supports A previously mild-mannered, cautious man becomes impulsive, disinhibited, and emotionally labile within weeks of a frontal lobe head injury, according to his family.
• raises alternative A lifelong pattern of impulsivity and poor judgement dating back to adolescence, with no brain injury or disease.
• contradicts or weakens No collateral history is available to confirm this represents an actual change from the person's previous personality.
• missing and necessary to ask What the person's personality and behaviour were like before the injury or illness, from a source who knew them well.

Duration and course

Minimum duration: The change should be sustained rather than transient, though onset can follow an acute brain injury or evolve with a chronic condition.

Course: Often persistent once established, particularly after structural brain injury; course can also reflect a slowly progressive underlying disease.

Included presentations

• Organic personality disorder following frontal lobe brain injury or disease.
• Postencephalitic syndrome: residual personality and behavioural change following brain infection.
• Postconcussional syndrome: a cluster of symptoms (including some personality/behavioural change) following head injury.

Exclusions and distinguishing presentations

Worked example — confirming a genuine change from baseline

A 38-year-old woman sustained a significant frontal lobe injury in a road traffic accident eight months ago. Her family describes her as previously reserved, conscientious, and cautious with money; since the injury, she has become impulsive, makes inappropriate jokes in formal settings, spends money without planning, and shows little concern about the effect of her behaviour on others. Formal cognitive testing shows only mild difficulty with planning tasks, with memory, language, and other domains intact.

1. Step 1 — Establish premorbid baseline: family collateral history confirms she was previously reserved and cautious, distinguishing the current pattern as a genuine change.
2. Step 2 — Check the nature of the change: disinhibition, impaired judgement, and altered social behaviour are described, consistent with a personality/behavioural change.
3. Step 3 — Check cognition: only mild planning difficulty is present; memory, language, and other domains are intact, weighing against dementia.
4. Step 4 — Check cause: a frontal lobe injury with a clear temporal link to the onset of the change is present.
5. Conclusion — The presentation is best classified as F07, supported by a confirmed brain injury, a genuine and collateral-confirmed change from baseline personality, and the absence of dominant global cognitive decline.

Interactive practice

• Type A Not who she used to be Recognition / application · Foundation
• Type B A diagnosis that could mean either Boundary / differential · Boundary

Retrieval prompts

Try answering each of these from memory before revealing where to check. Nothing you think or type here is sent or saved anywhere.

1. Without looking back at the page, state the one type of information that is essential before confirming a genuine personality change for F07.

   Reveal answer location

   Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.

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Related glossary terms

• Insight (clinical)

  The degree to which a person recognises that their experiences (such as unusual beliefs or perceptions) may reflect an illness rather than external reality. Insight can vary and is not itself a classification criterion, but is often noted educationally.

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• Cognitive domain

  A distinct area of mental functioning that can be separately assessed, such as memory, language, attention, planning/executive function, or visuospatial ability. Classifying organic mental disorders often depends on which domain(s) are affected and whether the pattern is isolated or multi-domain.

  Open full glossary entry →