RxPG - the perfect Rx for medical Post Graduate entrance blues!
Mobile Edition | Help/Newbie? | 24/7 Support
HOT | PrePG | MCQ | DNB | Careers | Books | Colleges | Dental | DocIndia | PLAB |  USMLE  | Australia | Canada | GLOBAL | OffBeat!
Articles | Forums | MCQ Crammer | Downloads | Mnemonics | Revision Tools | Recent Shouts | All Features

Organic mental disorders

Author: mugilakil, Posted on Sunday, December 11 @ 14:56:16 IST by RxPG  

 FRIEND Add to My Pages   PRINTER Printer Friendly   FRIEND Email Story  FRIEND Download Story  Psychiatry alerts 


Definition: - Psychiatric Disturbances resulting from transient or permanent Central Nervous System dysfunction.

Mental Illness à Underlying Brain Pathology

1. Acute Organic Mental Disorder (Delirium)

2. Chronic Organic Mental Disorder (Dementia)

Acute Condition – Sudden Onset, Reversible Impairment with time and Treatment

Chronic condition – Insidious Onset, Progression of Deterioration is slow and often irreversible

Delirium Dementia
1. Acute Onset Insidious Onset
2. Disorientation, Anxiety & Poor Attention Disturbed Memory & Personality Deterioration
3. Perceptual Abnormalities (illusions, Hallucinations) Global Impairment & Cerebral Function
4. Clouding of Consciousness Clear Consciousness
5. Fluctuating Course Progressive Course
6. Reversible Mostly Irreversible

DELIRIUM (Acute Organic Mental Disorder)

Delirium - Transient Organic Mental Disorders

- Generalised Physiological dysfunction, Usually fluctuating in Degree.

Clinical Features

- Sudden Onset
- Prodromal Period – Insomnia and Nightmares
- Clouding of Consciousness, Drowsiness, Restlessness and Inattentiveness
- Disorientation
- Impaired Attention Span
- Confused, Incoherent and Unitelligible Talk
- Fearful Mood
- Restless & Agitation
- Illusion (Visual)
- Visual & Auditory Hallucinations
- Delusional Ideas

Symptoms Fluctuating – Quiet during day & disturbed at Night
Amnesia – Not able to remember the symptoms of Previous Night
Duration – Few days to two weeks
Mild Delirium – In elder & severly ill patient
Severe Delirium – Severe Infection, Alcohol Withdrawal, Metabolic Diseases à Liver Failure & Uremia

Important Causes

Infections – Typhoid, Pneumonia, Septicaemia
Intracranial - Encephalitis, Meningitis, Neurosyphilis
Acute Brain Disorders – Head Injury, Cerebral Haemorrhage, Hypertensive Encephalopathy
Vitamin Deficiency – Pellagra, Wernicke’s Encephalopathy
Drug Withdrawal – Opiates, Batbiturates, Alcohol (Delirium Tremens)
Drug Intoxication – Atropine, Cocaine, Bromides


- Identify the Cause
- Investigate & treat the Cause
- Correct Symptoms
- Sedation for Disturbed Patients

Nursing Care

- Agitation – Physical Restraint

Patient Vital Signs

- Diet - Patients Exhausted & Die, Adequate Nourishment
- Rest
- Reassurance & Support

DEMENTIA (Chronic Organic Mental Disorder)

- Acquired Global Impairment of Intellect, Memory and Personality without Impairment of Consciousness
- Elder people – Dementia ********
- It is a Syndrome – due to disease of Brain – Chronic & Progressive in Nature
- Disturbance Higher function – Memory, thinking, Orientation, Compression, Learning Capacity, Language & Judgment
“Dementia is like a Dying Mind ina living Body”

- 5 % population aged over 65
- 10% over – 80

Classification of Dementia

1. Senile Dementia (Alzheimer’s Type)
2. Vascular Dementia
3. Dementia in Other Diseases
- Pick’s Diseases
- Creuzfeldt-Jakob Disease
- Huntington’s Disease
- Parkinson’s Disease
- HIV Disease
- Unspecified Dementia

Common Causes of Dementia

1. Degenerative (Cortical)
- Alzheimer’s Disease
- Pick’s Disease

2. Subcortical Degenerative
- Parkinson’s
- Huntington’s Disease
- Progressive Supranuclear Palsy
- Punch-drunk Syndrome

3. Infection and Inflammation
- Neurosyphilis (GPI)
- Creutzfeldt-Jakob Disease (Slow Virus)
- Multiple Sclerosis
- Post encephalitis

4. Toxic
- Alcohol
- Carbon Monoxide
- Heavy Metal Poisoning

5. Metabolic
- Hyupothyroidism
- Hypocalcaemi
- Hypoglycaemia
- Heptic encephalopathy
- Chronic uraemia and Dialysis
- Vit. B12 Deficiency
- Pellagra

6. Tumours
- Meningioma
- Benign Glioma
- Para-Pituitary Tumours
- Secondary Deposits
- Subdural Haematoma
- Normal Pressure Hydrocephalus

7. Trauma
- Head Injury

Clinical Features of Dementia

Impairment of Memory, Thinking & Judgement, Orientation, Comprehension & Learning Capacity, Calculation, Language

Diagnostic Criteria

1. Evidence of Organic Change
2. Evidence if Impairment in short and long-term memory
3. Impairment in Abstract Thinking, Judgment & Higher Cortical Function
4. Disturbance Interfering with work and Social Activities

Alzheimer’s Dementia

- Unknown Aetiology, Old Age (higher), Insidious Onset (Over period of Years), Presenile Period – May Occur, All Feutures Present, Brain Biopsy, Senile Plaques, Neuro Fibrillary Tangles, Granules & Ventricular Dilatation

Multi Infarct Dementia (Vascular Dementia) – Chronic Anoxia from Atherosclerosis, Cerebral and Systemic Vascular Disease, Associated with Hypertension, Course Stepwise & Fluctuating.

Pick’s Disease – Asymmetric Atrophy of the frontal and temporal lobes., Common in Females

Huntington’s Chorea - A Dementing disease with an autosomal dominant transmission, presenting with insidious onset of involuntary choreiform movement. The average age of onset is in the 30s.

Normal Pressure Hydrocephalus – Occurs mainly in the 7th and 8th decades and may be present with dementia. Unsteadiness of gait, urinary incontinence and nystagmus.
General Paralysis of Insane (GPI)

A condition of neurosyphilis leading on to dementia. Develops usually 10-20 years after initial infection (Syphilis) There is astrophy of the cerebral cortex, more severe in the frontal and temporal areas. Dementia is associated with depression, mania or schizophreniform psychosis. Other features include epilepsy, Argyll Robertson pupils, tremor, cerebellar or extra pyramidal symptoms, dysarthria, aphasia and hemiplegia

Management of Dementia

1. Drug Treatment – No Specific Drugs, Hygine, Papaverine, Piracetam, Sym**** treatment.
2. Psychosocial Management – Behavioural Methods, Milieu Therapy, Activity Engagement, Physical Exercise, Problem Oriented Approach, Reality Orientation, Organisation of Psychiatric Services

Nursing Care of Dementia

- Assess Patient’s Level of Functioning, Nurse the Patient in Familiar Surrounding, Due to Disorientation patient may be Wandering (Advice to tie ID-Card), Violent – May restrain, Simple Explanation & face to face Instruction, Stimuli – Noise – Visitors, Reassurance, Educating the Carer.

Psychiatric Aspects of Head Injury

Common Cause

- Road Accident, Fall from Height, Injury associated with alcoholism and Quarrels

Acute State

- Loss of Consciousness, Amnesia-retrograde,post traumatic, Delirium and Fits, Subdural Haematoma

Psychiatric Complication

- Dementia, Organic Personality Problem, Schizophrenia like Psychosis, Postconcussion Syndrome, Compensation Neurosis

4 (Excellent) 3(Good) 2(Good) 1(Bad)   

Recommended Books for Psychiatry
 Books to read for Psychiatry by RxPG

Related Psychiatry articles
 Syndromes in Psychiatry
 Psychiatric Defence mechanisms - An Overview
 ICD diagnostic criteria in sexual disorders
 Schizophrenia - Overview of this common psychiatric disorder
 Organic mental disorders
 Confusing Features of Hallucinations
 Neurotic and Stress-Related Disorders
 Mental Disorders - An Introduction
 Features of Obsessive Compulsive Neurosis
 Which is the schizophrenia with worst prognosis?
 Suicide - Commonest cause of death among Psychiatric Patients
 Psychiatry Clinical Examination Format with Examples
 Psychotherapy: An Overview
 Mood Disorders (Affective Disorder)
 Defense Mechanisms in Psychodynamic Theory
 Mental Retardation (SYN. Learning Disabilities, Intellectual Impairment)
 Donepezil - centrally acting reversible acetyl cholinesterase inhibitor
 Olanzapine - Thienobenzodiazepine Atypical Antipsychotic
 Risperidone - Most Commonly Used Atypical Antipsychotic
 Clozapine - The First Atypical Antipsychotic

Related Psychiatry Discussions

Other articles by mugilakil
 ICD diagnostic criteria in sexual disorders
 Schizophrenia - Overview of this common psychiatric disorder
 Organic mental disorders
 Neurotic and Stress-Related Disorders
 Mental Disorders - An Introduction
 Suicide - Commonest cause of death among Psychiatric Patients
 Psychiatry Clinical Examination Format with Examples
 Psychotherapy: An Overview
 Mood Disorders (Affective Disorder)
 Defense Mechanisms in Psychodynamic Theory
 Mental Retardation (SYN. Learning Disabilities, Intellectual Impairment)

 Psychiatry FAQ
  Browse all FAQs

Write an Article on Psychiatry
You can share your exam experiences, preparation strategies, books you have read or just any information about Psychiatry on RxPG website and we will publish it under your name.

Article Rating
Average Score: 4.33
Votes: 6

Most Read Article
Psychiatry; Free Online Mock Test 26

Related Links
· RxPG Postal Course
· Psychiatry Books at Amazon.com
· RxPG AIIMS Books
· Discuss Past Papers
· mediMOCK Forum
· RxPG Forums
· MRCPsych Forum


· Psychiatry section
· Articles by mugilakil
· Add to my pages
· Printer friendly version
· PDF version
· Email article
· Feedback on this article
· Medical tutorials
· Related forum posts
· Related articles
· Related downloads
· Submit article
· Psychiatry alerts
· Psychiatry books
· Psychiatry past papers

Most read story about Psychiatry:
Psychiatry; Free Online Mock Test 26

Server Status: 140 pages served in last minute. Page generation time: 0.030 seconds

Site Maps: [Books] [News] [Forums] [Reviews] [Mnemonics]

sitemap - top30 - centuries - testimonials

About Us :: Disclaimer :: Contact Us :: Reporting abuse :: Terms of Services :: Privacy Policy

Advertise with RxPG!
Made in India by RxPG Medical Solutions Private Limited

"RxPG" is a Registered Trademark

Chrome Web Store YouTube Twitter LinkedIn Wikipedia Facebook