Organic Disorders

Question 1

How are functional psychiatric disorders differentiated from organic psychiatric disorders?

Answer 1

Functional psychiatric disorders - disturbance of the functioning of the brain

Organic psychiatric disorders - Organic brain damage or mental disorder arising in the context of demonstrable physical disease

Question 2

What is the problem with differentiating functional from organic psychiatric disorders?

Answer 2

1 - Many psychiatric disorders have an organic basis (bipolar affective disorder, schizophrenia)

2 - Many mental disorders present with a mixture of mental and physical symptoms/features (depression)

3 - Physical disorders can have an effect on psychological functioning

Question 3

What are the categories of organic mental disorders?

Question 4

What are other terms used to describe organic mental disorders?

Answer 4

1 - Organic brain syndrome

2 - Organic brain disease

3 - Symptomatic mental disorder

Question 5

What are the common features of organic mental disorders?

Answer 5

1 - Cognitive Impairment

2 - Behavioural abnormalities

3 - Mood changes

4 - Psychotic features

Question 6

What symptoms might a patient with cognitive impairment from organic mental disorder present with?

Answer 6

1 - Disorientation

2 - Impaired attention

3 - Memory (anterograde +- retrograde amnesia)

4 - Problems with judgement

5 - Lack of insight

Question 7

What symptoms might a patient with behavioural abnormalities from organic mental disorder present with?

Answer 7

1 - Agitation & aggression

2 - Psychomotor retardation (slowing down - movements, speech, thoughts etc.)

3 - Abnormal social conduct

Question 8

What symptoms might a patient with mood changes from organic mental disorder present with?

Answer 8

1 - Low mood

2 - Anxiety

3 - Mania

Question 9

What symptoms might a patient with psychotic features from organic mental disorder present with?

Answer 9

1 - Hallucinations (visual most common)

2 - Delusions (often persecutory)

Question 10

How can organic mental disorders be categorised?

Answer 10

1 - Acute/subacute

2 - Chronic

Question 11

Give examples of organic mental disorders that can present acutely?

Answer 11

1 - Delirium

2 - Organic mood disorder

3 - Organic psychotic disorder

Question 12

Give examples of organic mental disorders that can present chronically?

Answer 12

1 - Dementia

2 - Amnesic syndrome

3 - Organic personality change

Question 13

What is the definition of delirium?

Answer 13

Transient organic mental syndrome of acute or subacute onset which is characterized by global cognitive impairment

Question 14

What are some of the presenting features of someone with delirium?

Answer 14

1 - Impaired attention/concentration

2 - Anterograde memory impairment

3 - Disorientation in time, place or person

4 - Changes in level of arousal (worse at night)

5 - Disordered sleep/wake cycle

6 - Disorganised thinking (rambling or irrelevant speech)

Question 15

What are some of the causes of delirium?

Answer 15

1 - Infections

2 - Medications

3 - Alcohol/drug withdrawal

4 - Drug abuse

5 - Metabolic

Question 16

What are some of the infective causes of delirium?

Answer 16

UTI’s

Respiratory infections (Pneumonia)

Question 17

What medications can cause delirium?

Answer 17

Anticholinergics

Dopaminergic

Opioids

Steroids

Question 18

What are some of the metabolic causes of delirium?

Answer 18

1 - Dehydration (electrolyte imbalance)

2 - Malnutrition

3 - Anaemia

4 - Hypoxia

5 - Hypercapnoea

Question 19

What is the definition of dementia?

Answer 19

A syndrome characterised by global cognitive impairment which is chronic in nature

The responsible brain pathology is usually progrssive

Question 20

List the different types of dementia?

Answer 20

1 - Alzheimers

2 - Vascular

3 - Lewy-body

4 - Fronto-temporal

5 - Other brain disorders (parkinsons, head injury, huntingtons chorea)

Question 21

What are the features of anterograde amnesia?

Answer 21

• Anterograde & retrograde amnesia

Preserved:

• Intellectual abilities
• Working memory
• Procedural memory

Question 22

What are the broad categories of the causes of amnesic syndrome?

Answer 22

1) Hippocampal damage
2) Diencephalic damage

Question 23

What can cause hippocampal damage, leading to amnesia?

Answer 23

Herpres-simplex virus encephalitis

Early alzheimers disease

Anoxia

Question 24

What are some of examples of conditions that can result in diencephalic damage leading to amnesia?

Answer 24

1 - Korsakoff’s syndrome (Thiamine (Vit B1) deficiency)

2 - Tumours of 3rd ventricle

3 - Infarction of Thalamus