Organic Mental Disorders and Learning Disabilities Flashcards
what are organic mental disorders?
mental disorders with a clear biochemical/physical aetiology
define primary and secondary organic mental disorders
primary - caused by a direct insult on the brain (eg tumour, infection)
secondary - caused by a systemic disease that affects the brain as well as other systems (eg infections, delirium, substance abuse)
name a few common cognitive features that present in organic mental illness
- memory impairment
- intellect decline
- learning impairment, especially new learning
name a a few sensory features which may present in organic mental illness
impaired consciousness
impaired attention
how is mood affected by organic mental illness?
it can cause both depression/anxiety and elation
what are the differences in psychotic symptoms in patients with organic vs psychiatric illness?
hallucinations - normally auditory in psychiatric illness, visual in organic illness
delusions - normally fluctuating/fragmented in organic disease, more consistent/systematised in psychiatric illness
are acute or chronic organic mental diseases more likely to be reversible?
acute
name a few examples of acute organic illness
delirium
organic mood disorder
organic psychiatric disorder
name a few examples of chronic organic illness
dementia
amnesic syndrome
organic personality change
drug/alcohol abuse
name a few features of delirium
impaired consciousness impaired attention cognition disturbance psychomotor disturbance sleep-wake cycle disturbance emotional disturbance
how is delirium treated?
- treat underlying cause
- treat contributing factors
- supportively managing remaining symptoms
what is typically the diurnal fluctuation of delirium?
patient tends to be more aware and alert during the day, and more anxious/agitated at night
how long can delirium last?
anything up to 6 months
in terms of timeline, what is the difference between dementia and delirium?
delirium often rapid onset following an insult
dementia is slower and more insidious
what is a downside of using benzodiazepines for delirium?
they can prolong the delirium
what neuroleptics are sometimes used in severe delirium?
antipsychotics
name an anticholinergic sometimes used to help treat delirium
promethazine
what is the difference between encephalopathy and delirium?
no difference in presentation, but delirium normally describes a psychiatric presentation, whereas encephalopathy describes a clear underlying cause (eg hepatic, Wernicke’s or HIV)
what is normally the cause of amnesic syndrome?
Korsakoff’s syndrome
what is the treatment of amnesic syndrome?
depends on the cause - if alcoholic, Vit B1/thiamine and nutrition, abstinence and MDT
in terms of memory, what are the features of amnesic syndrome?
- immediate recall preserved
- new learning reduced
- anterograde and retrograde memory amnesia
- confabulation
what IQ score is needed to qualify as having an intellectual impairment?
IQ < 70
one of which three criteria is needed to qualify as having a mental disorder?
learning disability
mental illness
personality disorder
what is the prevalence of learning disabilities?
1-2% of the population
