All mental changes that can be attributed to an organic disease, usually of the brain, are referred to as organic psychosyndrome. The old term “brain-organic psychosyndrome” is hardly ever used anymore. The organic psychosyndrome – or the physically justifiable psychosis – is generally divided into an acute and a chronic form.
What is Organic Psychosyndrome?
Physicians speak of an organic psychosyndrome when a psychological change (e.g. delirium, impaired consciousness, dementia, confusion, etc.) is based on an organic cause, such as a brain tumor, cerebral hemorrhage, encephalitis, or if this is the result of a craniocerebral trauma occurs. See usvsukenglish for What does the abbreviation HD stand for.
Not only different diseases of the brain can precede the organic psychosyndrome, also a variety of other physical diseases can be causally responsible for it. As an organically caused form, the organic psychosyndrome must be strictly distinguished from other types of mental change: from endogenous psychoses, ie psychoses that can be explained by the predisposition such as depression, mania or schizophrenia, and from exogenous psychoses, ie mental disorders caused by external factors.
Furthermore, in organic psychosyndrome, a distinction is made between acute organic psychosyndrome and acute organic psychosyndrome. In principle, age and cerebral or physical expansion play an important role in the prognosis and probable course of this disease or syndrome. Due to the large spectrum of possible causes, a diagnosis that is as precise as possible is a basic requirement for long-term effective therapy of the organic psychosyndrome.
The triggering causes can be as varied as the manifestations of an organic psychosyndrome. When dementia occurs, for example, various brain diseases can be present, such as a stroke (apoplexy), a craniocerebral trauma, a brain tumor, encephalitis or meningitis, a cerebral hemorrhage, but epilepsy is also an option here.
As far as non-cerebral causes are concerned, a wide variety of metabolic diseases can also be responsible for an organic psychosyndrome: These include high or low blood sugar (hyper- and hypoglycaemia), uremia, hyperthyroidism, but also liver failure or diabetes mellitus should be considered. Furthermore, severe infections such as urinary tract infections or [5sepsis]] (blood poisoning) can cause an organic psychosyndrome, as can neurodegenerative diseases such as Parkinson’s.
Poisoning (intoxication) through medication (e.g. antidepressants, neuroleptics, antihistamines), drugs or alcohol as well as the withdrawal symptoms from these can also play a role. Severe dehydration and the associated disruption of the water-salt balance in the body (exsiccosis) or a lack of oxygen (hypoxia) can also lead to an organic psychosyndrome.
Symptoms, Ailments & Signs
The first non-specific signs of an organic psychosyndrome can be memory disorders, lack of interest, behavioral problems and reduced physical performance. Anxiety often occurs, creativity and enthusiasm are lost. Those affected become indifferent to themselves and their environment, neglect personal hygiene and food intake.
An acute organic psychosyndrome can develop within hours. A clouding of consciousness, which is characterized by disorientation, fear or delusions, is characteristic. Hallucinations usually occur in the form of acoustic perceptions such as hearing voices or optical illusions; sensory illusions in the areas of smell, taste, touch or body perception are observed less frequently.
Delirium is usually accompanied by disorientation, hyperactivity, tremors, circulatory disorders and excessive sweating ; a hypoactive form of delirium is rare. Amnesia is characterized by a memory impairment in which a period of time has been erased from the person’s memory. Disorientation can affect time, place, people or the current situation of the patient.
The ability to think can be affected in many ways: slowed thinking, flight of ideas, erratic thinking or a narrowing of the scope of thinking occur. Mood swings that make you think of depression or bipolar disorder are also typical. Chronic organic psychosyndrome develops insidiously and is associated with progressive loss of mental abilities, personality changes and behavioral disorders.
Diagnosis & History
As far as the course and the diagnosis of the organic psychosyndrome are concerned, an exact specification in individual cases is necessary due to the large number of manifestations. As far as the characteristics and the basic course are concerned, there are two types of organic psychosyndrome.
Acute organic psychosyndrome includes: the affective syndrome with mood changes, the amnestic syndrome with memory disorders and loss, the twilight state with severe drowsiness and thought disorders, delirium in the form of excitement, palpitations, restlessness and hallucinations, hallucinosis, also with hallucinations, the isolated disturbance of consciousness with severe drowsiness, the spontaneous syndrome with lack of drive despite being awake up to coma, as well as a general state of confusion with disorientation.
These acute organic psychosyndromes are considered to be capable of regression or curable, but can – depending on the cause – also become chronic. The acute form is opposed to the chronic organic psychosyndrome: This usually occurs as a result of permanent damage to the brain. In this case, dementia with a dwindling intellectual memory and thinking capacity is often diagnosed, or also a frontal lobe syndrome or Korsakoff syndrome (brain-local psychosyndrome) as well as, for example, mutism or an apallic syndrome (so-called defect syndromes, e.g. after a coma). Also the hypersomnia-syndrome (sleep maniac) and the neurasthenic syndrome with nerve and cerebral inefficiency belong to the chronic organic psychosyndrome.
Depending on the cause, age and extent, chronic organic psychosyndromes can be stable or progressive. In order to predict a possible course or to initiate therapeutic steps, a comprehensive and precise diagnosis is therefore in the foreground in the case of organic psychosyndrome. The anamnesis includes an investigation of previous illnesses, possible trauma (accidents, injuries), the exclusion of infections and extensive neurological examinations.
In the laboratory, a complete blood count and a breakdown of the electrolytes are used. The differential diagnostic and imaging procedures include the EEG (electroencephalogram), a CCT (brain computed tomography), intracranial pressure measurement and, if necessary, a cerebrospinal fluid puncture.
In order to arrive at a diagnosis that is as accurate as possible, emotional behavioral abnormalities and changes (delusions, exhibitionism, depression, tantrums, mood swings, etc.) are looked for, as well as thought and memory disorders, states of anxiety, problems with orientation, lack of interest, exhaustion, and problems with eating or personal hygiene, drive disorders, etc., but also after general physical symptoms such as dizziness, sweating or nausea.
In this syndrome, patients suffer from a number of different psychological changes. This usually leads to a psychosis and other psychological upsets or depression. In many cases, the patients also suffer from social problems and can no longer maintain their social contacts. Inner restlessness or memory disorders also occur and are often accompanied by heart palpitations or sweating.
Disorders of concentration or orientation also occur with this syndrome and have a very negative effect on the quality of life of those affected. In many cases, this also leads to hallucinations or increased irritability of the person concerned. In many cases, the parents or relatives are severely affected by the symptoms of this syndrome.
In the worst case, the person concerned loses consciousness completely and falls into a coma. The treatment of this condition usually depends on its cause. However, a positive course cannot be guaranteed in every case. Taking psychotropic drugs can lead to various side effects in those affected and significantly reduce their quality of life.
When should you go to the doctor?
If people show signs or abnormalities in their personality, they should see a doctor. Disorders of consciousness, a clouded consciousness, confusion or a peculiarity of memory activity must be examined and treated. In the case of memory gaps or the inability to store knowledge and events in memory, a doctor is needed. A depressed mood, depressive states or apathy are signs of an existing health disorder. A doctor should be consulted so that the cause can be clarified.
Failure to meet daily obligations, delusions, or a strong euphoric mood are causes for concern. Anxiety, behavioral problems, heavy sweating or hallucinations are further indications of a mental illness. The person affected often lacks the necessary insight into the illness. Therefore, the support and help of people in the social environment is necessary. A relationship of trust must be established with the person concerned so that he or she consults a doctor.
In severe cases, a public health officer must be called in. Disorientation or circulatory irregularities are conditions that require treatment. Delusions of sensory perception are characteristic of an organic psychosyndrome. A doctor’s visit should be arranged as soon as possible so that the symptoms do not increase. Decreased well-being, inner restlessness and apathy should be presented to a doctor.
Treatment & Therapy
Individual treatment depends on the particular diagnosis. One of the most important therapeutic measures is of course the treatment of the underlying organic disease, as well and as far as this is possible. In acute organic psychosyndrome in particular, the causal therapy is decisive for the prognosis.
In addition, general stress reduction is extremely important, and depending on the form and causes, nutritional therapy (e.g. balancing the electrolytes) or drug therapy (e.g. with neuroleptics) can be possible therapy options. In the case of a newly occurring chronic organic psychosyndrome, rehabilitation is also at the beginning of medical treatment.
If no causal healing option can be found, it is important to alleviate the symptoms, such as hallucinations, restlessness or depression, with medication as best as possible. In many cases – especially in the case of damage to the brain – complete recovery is unlikely, so that it is precisely here that the symptoms must be improved.
In the case of purely physical, especially acute organic psychosyndromes, on the other hand, very good treatment successes can be achieved after the organic causes have been eliminated. This is the case, for example, with metabolic diseases or a disturbance in the electrolyte balance. In some cases, the course of therapy and its success also depend on the patient’s compliance, for example when alcohol abuse is the cause of the organic psychosyndrome.
Outlook & Forecast
The prognosis in the presence of an organic psychosyndrome always depends on the cause of the disease. In general, it can be said that there is a greater chance of recovery if the cause of the organic psychosyndrome is eliminated quickly and effectively.
In the case of an acute organic psychosyndrome in particular, the chances of recovery are described as very good. With this disease, it should be found out quickly what exactly triggered the deficit. Electrolyte disorders as well as hypernatremia, hyponatremia and craniocerebral trauma require their own individual treatment. If the course is milder, medication or antibiotics can provide rapid relief. Serious illnesses may also require surgical intervention to remove infected tissue. Once the cause of the organic psychosyndrome has been found, there is a good chance that the disease can be treated and cured.
If no cause for the organic psychosyndrome can be determined, the treatment is mainly aimed at reducing the symptoms of the body and psyche and thus improving the patient’s quality of life. Even if good treatment options are available nowadays, a positive course of the organic psychosyndrome cannot be guaranteed in every case. Regular preventive care and prompt treatment of the cause can significantly improve the prognosis of the disease.
Prevention or prophylaxis is hardly possible due to the wide range of symptoms and causes. A healthy, balanced lifestyle – also and especially with regard to mental balance – and avoiding alcohol and drugs can at least protect against an organic psychosyndrome caused by physical deficiency or stimulant toxins.
Regular check-ups also help to identify severe cerebral or organic diseases or metabolic diseases such as diabetes or liver and kidney problems at an early stage and thus prevent unfavorable courses. In addition, the following also applies to organic psychosyndrome: The earlier a diagnosis is made and effective therapy can be started, the better the chances of recovery.
Follow-up care should not be forgotten in organic psychosyndrome. This depends on the cause and underlying disease that led to the organic psychosyndrome. Through follow-up examinations, the patient’s psychosocial problems can be identified and addressed at an early stage. The doctor and therapist provide the patient with competent counseling content.
He recognizes the need for therapeutic approaches, self-help and other help at an early stage as part of the aftercare. In addition, regional rehabilitation options can be arranged. If patients join and use the aftercare networks for organic psychosyndrome, further inpatient stays can be shortened or prevented entirely.
If the patient is well supported through the follow-up care, he can learn more about himself and his illness through self-reflection. Perception changes. This may be more promising for some patients than years of psychotherapy. However, a broad time frame is required for follow-up treatments. Not every treatment is entirely promising. Frequently, new approaches are necessary by the doctor and therapist.
Long-term therapy in a psychotherapeutic group can also be helpful for the patient with organic psychosyndrome. Here the exchange with group members is very promising and useful. This promotes self-reflection and strengthens the tendency towards mental balance.
You can do that yourself
Due to the symptoms and immense impairment of brain functions, the disease does not offer the patient any opportunities for self-help. Normally, the affected person is dependent on daily support from other people and cannot take care of themselves. A stay in the hospital is often associated with the disease, since relatives are overwhelmed by the situation. If family members are caring for the person concerned, they must obtain comprehensive information about the manifestation of the mental disorder and its consequences.
The organic psychosyndrome can lead to antisocial behavior on the part of those affected. The people from the social environment urgently need to be informed about the disease and its consequences. Dealing with the patient with understanding is necessary so that the situation does not deteriorate or contacts are broken off. Since disorientation and confusion are other complaints, you should try to face the daily challenges calmly and patiently. The more stable the social environment and the more regulated the daily routine, the better it is for the patient.
Hectic, stress and excitement should be avoided. The everyday processes have to be organized and taken over by others because the person concerned is not able to do this. Hallucinations and hallucinations are common. In these moments, any provocation should be avoided.