Organic Disorders Flashcards
What characterises Functional psychiatric disorders?
characterised by disturbance of the functioning of the brain
What are organic mental disorder characterised by?
Characterised by demonstrable organic brain damage or mental disorder arising in the context of demonstrable physical disease
But there are issues with these definition because many (if not all) functional psychiatric disorders have organic basis eg. anxiety, depression. So why do we still use ‘organic mental disorders’?
- Group of disorders which have a recognised organic explanation
- Acquired - differentiation from learning disability
- Primary brain disorder/impairment versus secondary brain disorder (e.g. due to endocrine disorder, substance misuse)
What are other terms commonly used for organic mental disorders?
- Organic brain syndrome
- Organic brain disease
- Symptomatic mental disorder
What are common features of organic mental disorders?
- Cognitive impairment
- Behavioural abnormalities
- Mood changes
- Psychotic features
Please explain the common cognitive impairment features:
- Disorientation
- Impaired attention/concentration
- Memory (anterograde +/- retrograde amnesia)
- Language
- Judgement
- Insight
Please explain the common behavioural abnormalities:
- Agitation, aggression
- Slowing, psychomotor retardation
- Abnormal social conduct
Please explain the common mood changes:
- Low mood
- Anxiety
- Mania
Please explain the common psychotic features:
- Hallucinations, commonly visual
- Delusions (often persecutory)
What are the acute organic mental disorders?
- Delirium (acute organic confusional state)
- Organic mood disorder
- Organic psychotic disorder
What are the chronic organic mental disorders?
- Dementia
- Amnesic syndrome
- Organic personality change
What is Delirium?
Transient organic mental syndrome of acute or subacute onset which is characterised by global cognitive impairment
Presenting features of delirium?
- Impaired attention/concentration
- Anterograde memory impairment
- Disorientation in time, place or person
- Fluctuating levels of arousal (often nocturnal exacerbations)
- Disordered sleep/wake cycle
- Increased/decreased psychomotor activity
- Disorganised thinking as indicated by rambling, irrelevant or incoherent speech
- Perceptual distortions, leading to misidentification, illusions, and hallucinations
- Changes in mood such as anxiety, depression and lability
Causes of delirium?
- Infections
- Medications
- Alcohol/drug withdrawal
- Drug abuse
- Metabolic
- Vitamin deficiencies
- Endocrinopathies
- Neurological causes
- Toxins/industrial exposures
- SLE
- Cerebral vasculitis
- Paraneoplastic syndromes
What is dementia?
A syndrome which characterised by global cognitive impairment which is chronic in nature. The underlying brain pathology is variable and usually but not always progressive.
What are the different types of dementia?
- Alzheimer
- Vascular
- Lewy body
- Fronto-temporal
- Due to other brain disorders, e.g.
- Huntington’s chorea
- Head injury
- Parkinson’s disease
What is amnesic syndrome?
- Preserved global intellectual abilities
- Anterograde amnesia
- Retrograde amnesia (temporal gradient)
- Preserved registration/working memory (e.g. digit span)
- Preserved procedural (implicit) memory
What is anterograde anmesia?
Loss of the ability to create new memories after the event that caused amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact.
What is retrograde amnesia?
Loss of memory-access to events that occurred, or information that was learned, before an injury or the onset of a disease.
What are the two main causes of amnesic syndrome?
Hippocampal damage
- Herpes simplex virus encephalitis
- Anoxia
- Surgical removal of temporal lobes
- Bilateral posterior cerebral artery occlusion
- Closed head injury
- Early Alzheimer’s disease
Diencephalic damage
- Korsakoff’s syndrome (alcoholic and non-alcoholic)
- 3rd ventricle tumours and cysts
- Bilateral thalamic infarction
- Post subarachnoid haemorrhage, especially from anterior communicating artery aneurysms
