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Flashcards in Organic Conditions Deck (18):
1

What is the difference between functional psychiatric disorders and organic mental disorders?

Functional psychiatric disorders - characterised by disturbance of the functioning of the brain
Organic mental disorders - characterised by demonstrable organic brain damage or mental disorder arising in the context of demonstrable physical disease

2

What are the problems with the distinction between functional psychiatric disorders and organic mental 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

3

What are organic mental disorders?

Group of disorders which have a recognised organic explanation
Acquired - differentiation from learning disability
Primary brain disorder/impairment vs secondary brain disorder e.g. due to substance misuse

4

What cognitive impairments are seen in organic mental disorders?

Disorientation
Impaired attention/concentration
Memory - anterograde +/- retrograde amnesia
Language
Judgement
Insight

5

What behavioural abnormalities are seen in organic mental disorders?

Agitation, aggression
Slowing - psychomotor retardation
Abnormal social conduct

6

What mood changes are seen in organic mental disorders?

Low mood
Anxiety
Mania

7

What psychotic features are seen in organic mental disorders?

Hallucinations, commonly visual
Delusions, often persecutory

8

What are the acute/subacute organic mental disorders?

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

9

What are the chronic organic mental disorders?

Dementia
Amnesic syndrome
Organic personality change

10

What is delirium?

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

11

What are the presenting features of delirium?

Impaired attention/concentration
Anterograde memory impairment
Disorientation in time, place or person
Fluctuating levels of arousal (often nocturnal exacerbations)
Disordered sleep/wake cycle
Increased/decreased psychomotor activity
Disorganised thinking indicated by rambling, irrelevant or incoherent speech
Perceptual distortions leading to misidentification, illusions and hallucinations
Changes in mood e.g. anxiety, depression and lability

12

What are the causes of delirium?

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

13

What is dementia?

A syndrome characterised by global cognitive impairment which is chronic in nature
The underlying brain pathology is variable and usually, but not always, aggressive

14

What are the types of dementia?

Alzheimer's disease
Vascular
Lewy body
Fronto-temporal
Dementia due to other brain disorders;
- Huntington's chorea
- Head injury
- Parkinson's disease

15

What are the features of amnesic syndrome?

Preserved global intellectual abilities
Anterograde amnesia
Retrograde amnesia (temporal gradient)
Preserved registration/working memory
Preserved procedural memory

16

What are the causes of amnesic syndrome?

Hippocampal damage
Diencephalic damage

17

What are the causes of hippocampal damage?

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

18

What are the causes of diencephalic damage?

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