Descompensation

Descompensation (more commonly termed decompensation in English) denotes the loss of the ability of an organ, physiological system, or psychological coping mechanism to maintain function in the face of stress or disease. It is a descriptive term rather than a specific diagnosis and is used across medicine and psychiatry to denote clinical deterioration that follows an overwhelmed compensatory capacity.

In medicine, descompensation often refers to acute worsening of chronic conditions—examples include cardiac decompensation (heart failure with symptoms such as shortness of breath, edema, reduced exercise tolerance), hepatic decompensation (jaundice, ascites, variceal bleeding, hepatic encephalopathy), and respiratory decompensation (respiratory failure requiring ventilatory support). Triggers include infection, ischemia, fluid overload, metabolic derangements, or medication nonadherence. Identification relies on clinical assessment supplemented by laboratory tests and imaging; management focuses on stabilizing the patient and treating the underlying cause.

In psychiatry, descompensation describes the breakdown of adaptive defenses or coping strategies, leading to exacerbation of psychiatric symptoms such as psychosis, severe anxiety, depressive relapse, or behavioral dysregulation. Precipitants can be psychosocial stress, substance use, sleep deprivation, or medical illness. Response may require acute psychiatric care, medication adjustment, and psychosocial support.

Prognosis varies with the underlying condition, promptness of intervention, and baseline reserve. Preventive measures emphasize early detection, adherence to treatment, risk-factor control, and timely medical or psychiatric follow-up. The term’s usage and spelling vary by language and clinical context.