Organic mental disorders Flashcards
What are ‘organic mental disorders’?
An underlying “physical” disorder as the cause of the mental disturbance.
They can be primary or secondary:
- Primary – neurological disorder having direct effect on the brain
- Secondary – systemic diseases that affect the brain in addition to other systems/organs i.e endocrine disorders or substance induced problems (alcohol/drug)
Common features seen in organic disorders?
- Cognitive - memory, intellect, learning (but not learning disabilities)
- Sensorium - consciousness, attention
- Mood - depression, elation, anxiety
- Psychotic - hallucinations, delusions
- Personality and behavioural disturbances - phineas gage
- Onset - any age but most primary organic disorders tend to start in adult or later life
- Some irreversible and progressive whilst some are transient/respond to treatments
Give 3 examples of acute / sub-acute organic brain disorders
- Delirium
- Organic mood disorder
- Organic psychotic disorder
Give 3 examples of chronic organic mental disorders
- Dementia
- Amnesic syndrome
- Organic personality change
Chronic organic mental disorders
Chronic organic brain syndrome is long-term.
- For example, some forms of chronic drug or alcohol dependence can cause organic brain syndrome due to their long-lasting or permanent toxic effects on brain function.
- Other common causes sometimes listed are the various types of dementia which result from permanent brain damage due to strokes, Alzheimer’s disease, or other damaging causes which are not reversible.
Acute organic mental disorders
Acute organic brain syndrome is (by definition) a recently appearing state of mental impairment, as a result of intoxication, drug overdose, infection, pain, and many other physical problems affecting mental status.
In medical contexts, “acute” means “of recent onset”. As is the case with most acute disease problems, acute organic brain syndrome is often temporary–however this is not guaranteed (a recent-onset problem may continue to be chronic or long term).
Name some of the psychiatric symptoms of Delirium tremens
- Fluctuating confusion
- Disorientation in time and place
- Memory impairment
- Psychotic phenomena e.g hallucinations or dellusional thinking
- Tremor
- Agitation
- Sleeplessness
- Autonomic over-activity - sweating etc
What causes Wernicke-Korsakoff syndrome?
Acute deficiency of Thiamine (Vitamin B1)
Symptoms associated with Wernicke’s Encephalopathy
- Acute confsuional state
- Ataxia
- Opthalmoplegia
- Nystagmus
With treatment confusional state and opthalmoplegia can resolve within days. However, nystagmus, neuropathy and ataxia may be prolonged or permanent.
Symptoms of Alcohol Amnesic Syndrome (Korsakoff’s psychosis)
- Marked impairment of anterograde memory (ability to learn new information) and retrograde memory
- Preservation of immediate recall
- Disturbance of time sense
- Variable degrees of cognitive impairment
- Personality changes, apathy, loss of initiative
- Confabulation in the early stage - they confuse things they have imagined with real memories (not lying).
- No general cognitive impairment
Psychiatric symptoms in Hepatic Encephalopathy
General psychomotor retardation
Drowsiness
Fluctuating levels of confusion
Disorientation
What causes the psychiatric symptoms in Hepatic Encephalopathy?
A build up of toxic products (e.g. ammonia) - the liver can no longer process it.
How can alcohol related brain damage come about? (7)
- Neurotoxic effects of alcohol
- Head injury
- Vitamin deficiencies
- Cerebrovascular disease
- Hypoxia
- Hypoglycaemia
- Seizures
50-80% heavy drinkers display cognitive impairment when sober
Define dementia
A syndrome which is characterised by global cognitive impairment which is chronic in nature.
Types of dementia
- Alzheimer
- Vascular
- (Mixed - alzheimer’s and vascular)
- Lewy body
- Frontotemporal
Due to other brain disorders:
- Huntington’s chorea
- Head injury
- Parkinson’s disease
Delirium vs. Dementia
