Organic Mental Disorders Flashcards
What is the definition of organic mental disorders?
Due to common, demonstrable aetiology in cerebral disease, brain injury or other insult leading to cerebral dysfunction
Describe primary vs secondary organism mental disorders
Primary; direct effect on brain
Secondary; systemic diseases affecting brain in addition to other systems/organs i.e. endocrine/substances
What are common features of organic mental disorders?
Cognitive; memory, intellect, learning
Sensorium; consciousness, attention
Mood; depression, elation, anxiety
Psychotic; hallucinations, delusions
Personality and behavioural disturbance
What are some acute causes of organic brain disorders?
Delirium
Organic mood disorder
Organic psychotic disorder
What are some chronic causes of organic brain syndrome?
Dementia/AD
Amnesic syndrome
Organic personality change
What are screening tools for delirium?
CAM
4AT
What are presenting features of delirium?
- impaired consciousness and attention
- global disturbance of cognition
- psychomotor disturbances
- disturbance of sleep-wake cycle
- emotional disturbance
- rapid onset
- diurnal fluctuation
- duration <6mnths
How is delirium managed?
Treat underlying cause
Environmental and supportive measures; educate relatives, make environment safe, orientation
Correct contributing factors i.e. dehydration, hypoxia, infection, pain, poor nutrition etc.
Encephalopathy vs Delirium
Different descriptions of same presentation
Delirium describes the psychiatric presentation, encephalopathy describes the underlying process
Describe hepatic encephalopathy
Generally seen in advanced liver disease
- psychomotor retardation
- drowsiness
- fluctuating confusion
- asterixis
Related to build-up of toxic products
Describe amnesic syndrome
Syndrome of impairment of recent and remote memory
Immediate recall preserved
New learning reduced
Anterograde amnesia
Disorientation in time
Retrograde amnesia
Confabulation
Perception and other cognitive functions preserved
What is confabulation?
Made up stories to fill in gaps in memory
Anterograde vs retrograde amnesia
Anterograde; loss of ability to make new memories whilst long-term remains intact
Retrograde; loss of memory from the past including events that occurred
Describe diencephalic damage in amnesic syndrome
Korsacoff’s syndrome (alcoholic and non-alcoholic)
3rd ventricle tumours and cysts
Bilateral thalamic infection
Post SAH
Describe hippocampal damage in amnesic syndrome
Herpes simplex virus encephalitis
Anoxia
Surgical removal of temporal lobes
Bilateral posterior cerebral artery occlusion
Closed head injury
Early AD
