Organic Mental Disorders Flashcards
What are functional psychiatric disorders characterised by?
Characterised by disturbance of the functioning of the brain
What are organic mental disorders characterised by?
Characterised by demonstrable organic brain damage or mental disorder arising in the context of demonstrable physical disease
What problems are there with the divide between functional and organic disorders?
- Many (if not all) functional psychiatric disorders have organic basis,e.g. bipolar affective disorder, schizophrenia
- Many if not all mental disorders present with a mixture of mental and physical features, e.g. depression
- Physical disorders also have effect on psychological functioning
What are organic mental disorders?
A group of acquired disorders (differentiation from leaning disability) which have a recognised organic explanation
What can cause organic mental disorders?
- Primary brain disorder/ impairment such as a tumour
- Secondary brain disorder such as and endocrine disorder or substance misuse
What other terms are there for organic mental disorder?
- Organic brain syndrome
- Organic brain disease
- Symptomatic mental disorder
What are the common cognitive features of organic mental disorders?
- Disorientation
- Impaired attention/concentration
- Memory (anterograde +/- retrograde amnesia)
- Language difficulties
- Issues with judgement
- Loss of insight
What are the common behavioural abnormalities of organic mental disorders?
- Agitation, aggression
- Slowing, psychomotor retardation
- Abnormal social conduct
What are the common mood changes of organic mental disorders?
- Low mood
- Anxiety
- Mania
What are the common psychotic features of organic mental disorders?
- Hallucinations, commonly visual
- Delusions (often persecutory)
Give examples of acute/subacute organic mental disorders.
- Delirium (acute organic confusional state)
- Organic mood disorder
- Organic psychotic disorder
Give examples of chronic organic mental disorders.
- Dementia
- Amnesic syndrome
- Organic personality change
What is delirium?
A Transient organic mental syndrome
of acute or subacute onset which
is characterised by
global cognitive impairment
What are the presenting features of delirium?
- Impaired attention/concentration -Anterograde memory impairment
- Disorientation
- Fluctuating levels of arousal (often nocturnal exacerbations)
- Disordered sleep/wake cycle
- Increased/decreased psychomotor activity
- Disorganised thinking
- Perceptual distortions,
- Changes in mood such as anxiety, depression and lability
What are the 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.
Give examples of types of dementia.
- Alzheimer
- Vascular
- Lewy body
- Fronto-temporal
- Due to other brain disorders
What other brain disorders can cause dementia?
- Huntington’s chorea
- Head injury
- Parkinson’s disease
What are the features of 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 causes of hippocampal damage can lead to amnesic syndrome?
- Herpes simplex virus encephalitis
- Anoxia
- Surgical removal of temporal lobes
- Bilateral posterior cerebral artery occlusion
- Closed head injury
- Early Alzheimer’s disease
What causes of diencephalic damage can lead to amnesic syndrome?
- Korsakoff’s syndrome (alcoholic and non-alcoholic)
- 3rd ventricle tumours and cysts
- Bilateral thalamic infarction
- Post subarachnoid haemorrhage, especially from anterior communicating artery aneurysms
