Organic Mental Disorders Flashcards
(49 cards)
What makes a disorder an OMD?
Recognised as having an organic explanation Acquired (i.e. not a LD) Primary (brain) or secondary (e.g. endocrine)
What areas of mental health do OMDs affect?
Cognitive impairment Sensorium Mood changes Psychotic symptoms Personality and behavioural disturbance
What are the major acute OMDs?
Delirium Organic Mood disorder Organic Psychotic disorder
What is delirium?
Transient & fluctuating global cognitive impairment with ass. behavioural changes
What are the defining characteristics of delirium?
- Impaired attention/conc - Disorientated (Time, place, person) - Fluctuating arousal (quiet/drowsy –> agitated outburst) particularly at night - Perceptual problems e.g. hallucination - Mood changes - Delusions - Disorganised thinking & speech Also ant memory, sleep/wake cycle and psychomotor problems
Virtually any neuro or systemic problem can –> delirium, what are the most common?
Infection Drugs e.g. steroids/opioids (both common post-op) Withdrawal e.g. alc Alc use Liver/kidney disease Hypoxia Lot’s of others in brain, vit deficiencies, metabolic problems and endocrinopathies
What are the commonest chronic OMDs?
Dementia Amnesic Syndrome ORganic Personality Change
What makes dementia different to Delirium?
It’s a chronic and progessive global cognitive impairment, It also doesn’t fluctuate much
Define amnesic syndrome?
Ant AND Retrograde amnesia with preserved intellectual abilities, working memory & procedural memory
What can cause amnesic syndrome>?
Hippocampal damage e.g. HSV or bilateral post-cerebral art occlusion Diencephalic damage e.g. Korsakoff’s syndrome, 3rd ventricle tumours and post-subarachnoid haemorrhage problems such as ant communicating art aneurysm
How may cognitive function be affected in OMDs?
Memory Intellect Learning
How may sensorium be affected in OMDs?
Consciousness Attention
How may mood be affected in OMDs?
Depression Elation Anxiety
How may psychosis be affected in OMDs?
Hallucinations Delusions
When do OMDs onset?
Any age Most tend to start in adult or later life
Hw chronic are OMDs?
Some irreversible and progressive Some transient/respond to treatments
How may an OMD be classified and what are some subtypes?
Acute/sub-acute -Delirium -Organic mood disorder -Organic psychotic disorder Chronic -Dementia -Amnesic syndrome -Organic personality change
How is delirium tremens treated?
Benzodiazepines
If Wernicke’s encephalopathy goes untreated, how many will develop Korsakoff psychosis?
84% (after 2 week untrusted acute phase)
How is Wernicke-Korsakoff Syndrome treated?
High potency parenteral B1 replacement -3-7 days -Oral thiamine -Avoid carbohydrate load until thiamine replacement completed -All patients with symptoms of Wernike’s encephalopathy or at high risk should be treated with parenteral thiamine -Others undergoing detoxification or under investigation should be commenced on oral thiamine -Concurrent treatment for alcohol withdrawal
What can Korsokoff’s psychosis also be known as?
Alcohol Amnesic Syndrome
How does Korsokoff’s present?
-Characterised by marked impairment of anterograde memory (ability to learn new information), disturbance of time sense -No clouding of consciousness, absence of defect in immediate recall or global impairment -Variable degrees of cognitive impairment -Personality changes, apathy, loss of initiative -Confabulation in the early stage -Can improve with prolonged abstinence
What is hepatic encephalopathy?
-Normally seen in advanced alcohol liver disease -General psychomotor retardation, drowsiness fluctuating levels of confusion -Related to build up of toxic products (e.g. ammonia) -Improves if and as liver function recovers
What is alcohol-related brain damage?
-Part of a spectrum of alcohol related medical disorders, not a specific diagnosis -Can result from neurotoxic effects of alcohol, head injury, vitamin deficiencies, cerebrovascular disease, hypoxia, hypoglycaemia, seizures
