Organic Mental Disorders

Question 1

What are functional psychiatric disorders characterised by?

Answer 1

Characterised by disturbance of the functioning of the brain

Question 2

What are organic mental disorders characterised by?

Answer 2

Characterised by demonstrable organic brain damage or mental disorder arising in the context of demonstrable physical disease

Question 3

What problems are there with the divide between functional and organic disorders?

Answer 3

• 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

Question 4

What are organic mental disorders?

Answer 4

A group of acquired disorders (differentiation from leaning disability) which have a recognised organic explanation

Question 5

What can cause organic mental disorders?

Answer 5

• Primary brain disorder/ impairment such as a tumour

- Secondary brain disorder such as and endocrine disorder or substance misuse

Question 6

What other terms are there for organic mental disorder?

Answer 6

• Organic brain syndrome
• Organic brain disease
• Symptomatic mental disorder

Question 7

What are the common cognitive features of organic mental disorders?

Answer 7

• Disorientation
• Impaired attention/concentration
• Memory (anterograde +/- retrograde amnesia)
• Language difficulties
• Issues with judgement
• Loss of insight

Question 8

What are the common behavioural abnormalities of organic mental disorders?

Answer 8

• Agitation, aggression
• Slowing, psychomotor retardation
• Abnormal social conduct

Question 9

What are the common mood changes of organic mental disorders?

Answer 9

• Low mood
• Anxiety
• Mania

Question 10

What are the common psychotic features of organic mental disorders?

Answer 10

• Hallucinations, commonly visual

- Delusions (often persecutory)

Question 11

Give examples of acute/subacute organic mental disorders.

Answer 11

• Delirium (acute organic confusional state)
• Organic mood disorder
• Organic psychotic disorder

Question 12

Give examples of chronic organic mental disorders.

Answer 12

• Dementia
• Amnesic syndrome
• Organic personality change

Question 13

What is delirium?

Answer 13

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

Question 14

What are the presenting features of delirium?

Answer 14

• 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

Question 15

What are the causes of delirium?

Answer 15

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

Question 16

What is dementia?

Answer 16

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.

Question 17

Give examples of types of dementia.

Answer 17

• Alzheimer
• Vascular
• Lewy body
• Fronto-temporal
• Due to other brain disorders

Question 18

What other brain disorders can cause dementia?

Answer 18

• Huntington’s chorea
• Head injury
• Parkinson’s disease

Question 19

What are the features of amnesic syndrome?

Answer 19

• Preserved global intellectual abilities
• Anterograde amnesia
• Retrograde amnesia (temporal gradient)
• Preserved registration/working memory (e.g. digit span)
• Preserved procedural (implicit) memory

Question 20

What causes of hippocampal damage can lead to amnesic syndrome?

Answer 20

• Herpes simplex virus encephalitis
• Anoxia
• Surgical removal of temporal lobes
• Bilateral posterior cerebral artery occlusion
• Closed head injury
• Early Alzheimer’s disease

Question 21

What causes of diencephalic damage can lead to amnesic syndrome?

Answer 21

• Korsakoff’s syndrome (alcoholic and non-alcoholic)
• 3rd ventricle tumours and cysts
• Bilateral thalamic infarction
• Post subarachnoid haemorrhage, especially from anterior communicating artery aneurysms