Organic Disorders

Question 1

Define functional psychiatric disorders

Answer 1

Characterised by disturbance of the functioning of the brain

Question 2

Define organic mental disorder

Answer 2

Group of disorders which have a recognised organic explanation

Question 3

What are the different kinds of organic mental disorders?

Answer 3

Acquired vs learning disability

Primary brain disorder vs secondary brain disorder (e.g. due to endocrine disorder/substance misuse)

Question 4

What are some common features of organic mental disorders?

Answer 4

Cognitive impairment (disorientation, impaired attention/concentration, amnesia, language, judgement and insight problems)

Behavioural abnormalities (agitation, aggression, retardation, abnormal social conduct)

Mood changes (low mood, anxiety, mania)

Psychotic features (visual hallucinations, persecutory delusions most common)

Question 5

What are some of the acute/subacute organic mental disorders?

Answer 5

Delirium/acute confusional state
Organic mood disorder
Organic psychotic disorder

Question 6

What are some of the chronic organic mental disorders?

Answer 6

Dementia
Amnesic syndrome
Organic personality change

Question 7

Define delirium

Answer 7

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

Question 8

What are the presenting features of delirium?

Answer 8

Impaired attention/concentration
Anterograde amnesia 
Disorientation (TPP)
Fluctuating levels of arousal 
Worse at night
Disordered sleep-wake cycle
Increased/decrease psychomotor activity
Disorganised thinking
Perceptual distortions (illusions, hallucinations) 
Mood changes - anxiety, depression, liability

Question 9

List some causes of delirium

Answer 9

Infections
Medications
Alcohol/drug withdrawal 
Drug abuse
Metabolic
Vitamin deficiencies
Endocrinopathies
Neurological causes
Toxins/industrial exposures
SLE
Cerebral vasculitis
Paraneoplastic syndrome

Question 10

What are the types of dementia?

Answer 10

Alzheimer's
Vascular
Lewy body 
Fronto-temporal
Due to other brain disorders, e.g. Huntington's, head injury, Parkinson's

Question 11

What is amnesic syndrome?

Answer 11

Permanent memory impairment which can be in the anterograde or retrograde from
There is preserved registration & working memory and procedure (implicit memory)

Question 12

What causes amnesic syndrome?

Answer 12

Direct/indirect damage to the memory areas in the brain:

1. Diencephalon (which includes the third ventricle, thalamus, hypothalamus & pituitary gland)
2. Cortical areas – medial temporal lobe, especially the hippocampus

Question 13

What things can cause hippocampal damage?

Answer 13

HSV encephalitis
Anoxia
Surgical removal of temporal lobes
Bilateral posterior cerebral artery occlusion Closed head injury 
Early Alzheimer's

Question 14

What things can cause diencephalic damage?

Answer 14

Korsakoff’s
3rd ventricle tumour/cyst
Bilateral thalamic infarction
Post-SAH