2.1.11 Organic Psychoses

Organic Psychoses

By their very nature, all mental disorders are organic, meaning they involve deviations from the normal development or operation of the brain. However, the phrase “organic sickness” in contemporary psychiatric classification refers to those illnesses with a proven genesis in pathology of the central nervous system (CNS).

Organic psychoses refer to a group of mental disorders that arise from underlying medical conditions that affect the brain. These disorders are distinct from functional psychoses, such as schizophrenia or bipolar disorder, which do not have a clear organic cause. Organic psychoses can result from a variety of factors, including traumatic brain injury, infections, metabolic disorders, substance abuse, and tumours. The symptoms of organic psychoses can vary widely depending on the underlying cause and can include delusions, hallucinations, mood changes, cognitive impairments, and behavioural disturbances. Accurate diagnosis and treatment of organic psychoses require a thorough medical evaluation to identify and address the underlying medical condition. Despite the significant impact of organic psychoses on the affected individuals and their families, these disorders remain poorly understood and often underdiagnosed. Therefore, further research is necessary to better understand the aetiology, diagnosis, and treatment of organic psychoses.

Prevalence/Incidence:

Organic psychoses are a relatively rare group of mental disorders, and their exact incidence and prevalence in the UK are not well established. However, some studies suggest that the prevalence of organic psychoses is estimated to be between 0.03% and 0.3% of the general population. Organic psychoses tend to be more common in older adults and can be associated with underlying medical conditions such as dementia, brain injury, or infections. The incidence and prevalence of organic psychoses may vary depending on the specific underlying medical conditions and the population studied. Nonetheless, it is important to note that organic psychoses can have a significant impact on affected individuals and their families, highlighting the importance of accurate diagnosis and appropriate treatment.

Aetiology:

The aetiology of organic psychoses in the UK can vary widely depending on the underlying medical conditions that cause them. Traumatic brain injury, infections, metabolic disorders, substance abuse, and tumours are some of the common causes of organic psychoses. In older adults, dementia-related conditions such as Alzheimer’s disease or vascular dementia are frequent causes of organic psychoses. Other factors such as genetics, environmental exposures, and lifestyle factors may also contribute to the development of organic psychoses. Understanding the aetiology of organic psychoses is essential for accurate diagnosis and appropriate treatment, which typically involves addressing the underlying medical condition. Therefore, a thorough medical evaluation is necessary to identify and manage the specific cause of organic psychosis.

Presentation:

The presentation of organic psychoses can vary widely depending on the underlying medical condition that causes them. Common symptoms of organic psychoses include delusions, hallucinations, mood changes, cognitive impairments, and behavioral disturbances. These symptoms may be acute or develop gradually over time, depending on the underlying cause. In some cases, the symptoms of organic psychoses may mimic those of functional psychoses such as schizophrenia, making accurate diagnosis challenging. In older adults, organic psychoses may present with symptoms of dementia, including memory loss, confusion, and disorientation. The specific presentation of organic psychoses will depend on the underlying medical condition and may require a thorough medical evaluation to identify the cause and provide appropriate treatment.

Treatment:

The treatment of organic psychoses typically involves addressing the underlying cause of the disorder, as well as managing any associated symptoms or complications. In some cases, medication may be prescribed to help manage symptoms such as psychosis or mood instability. Other treatments may include psychotherapy, rehabilitation, or other supportive interventions aimed at improving quality of life and overall functioning (Ropper, 2019).

Outcome:

The prognosis for organic psychoses and other psychiatric disorders can vary widely depending on the specific disorder and the underlying cause. In some cases, these disorders may be temporary and resolved with appropriate treatment. In other cases, however, the effects of the disorder may be long-lasting and may significantly impact an individual’s quality of life and overall functioning.

	Organic Psychosis
Definition	A group of psychiatric disorders caused by physical and/or organic factors that affect brain function.
Prevalence/Incidence	0.03 – 0.3%
Aetiology	Brain injury, tumours, infections, substance abuse, medical conditions.
Risk Factors	Head injury, infections, substance abuse, medical conditions.
Signs and Symptoms	Confusion, disorientation, delusions, hallucinations, memory impairment.
Diagnosis	Based on symptoms and physical examination, as well as laboratory and imaging tests.
Treatment and Outcome	Address the underlying cause, medication, psychotherapy, and rehabilitation. Prognosis varies depending on specific disorder and cause.

References:

1. Ropper, A. H. (2019). Adams and Victor’s principles of neurology (11th ed.). McGraw Hill Education.
2. Schechter, M., & Rakofsky, J. J. (2012). Organic mental disorders. In Diagnostic and statistical manual of mental disorders (DSM-5) (pp. 31-37). American Psychiatric Association.