Medicine:Organic mental disorder

An organic mental disorder (OMD), also known as organic brain syndrome or chronic organic brain syndrome, is a form of decreased mental function due to a medical or physical disease, rather than a psychiatric illness. This differs from dementia. While mental or behavioral abnormalities related to the dysfunction can be permanent, treating the disease early may prevent permanent damage in addition to fully restoring mental functions. An organic cause to brain dysfunction is suspected when there is no indication of a clearly defined psychiatric or "inorganic" cause, such as a mood disorder.

Now the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision) has broken up the diagnoses that once fell under the diagnostic category organic mental disorder into three categories: delirium, dementia, and amnestic.

Delirium, a mental confusion and emotional disruption, is caused by the sudden change in the brain. Thinking, remembering, sleeping, and paying attention can become difficult during alcohol withdrawal, after surgery, or with dementia. Dementia, a decline in mental ability, can be severe or not, and can interfere with daily life and cause memory loss in most instances. Amnestic pertains to amnesia and is the impairment in ability to learn or recall new information, or recall previously learned information. Although similar, it is not coupled with dementia or delirium.

Organic brain syndrome can be divided into 2 major subgroups: acute (delirium or acute confusional state) and chronic (dementia). A third entity, encephalopathy (subacute organic brain syndrome), denotes a gray zone between delirium and dementia; its early course may fluctuate, but it is often persistent and progressive. Damage to brain functioning could be due not only to organic (physical) injury (a severe blow to the head, stroke, chemical and toxic exposures, organic brain disease, substance abuse, etc.) and also to non-organic means such as severe deprivation, abuse, neglect, and severe psychological trauma.

Alternative names

• Organic Brain Syndrome
• OBS
• Organic Mental Syndrome
• OMS
• Chronic Organic Brain Syndrome

Symptoms

Many of the symptoms of Organic Mental Disorder depend on the cause of the disorder, but are similar and include physical or behavioral elements. Dementia and delirium are the cause of the confusion, orientation, cognition or alertness impairment. Therefore, these symptoms require more attention because hallucinations, delusions, amnesia, and personality changes are the result. These effects of the dementia and delirium are not joined with the changes of sensory or perception abilities. Memory impairment, judgment, logical function and agitation are also some extremely common symptoms.

Treatment

While the treatment depends on which particular disorder is involved in Organic Mental Disorder, a few that are possible. Treatments can include, but are not limited to, rehabilitation therapy such as physical or occupational, pharmacological modification of the neurotransmitter function, or medication. The affected parts of the brain can recover some function with the help of different types of therapy. Online therapy can be just as intense and helpful as rehabilitation therapy, in person, and can help those affected regain function in daily life.

Prognosis

Some disorders are short-term and treatable, and their prognosis is not as lengthy. Rest and medication are the most common courses of action for these treatable cases to help the patient return to proper health. Many of the cases are long-term, and there is not as much of a set and defined prognosis. The course of action can include extensive counseling and therapy. There are many reasons that the long-term cases are harder to treat and these include these cases normally get worse over time, and medication or therapy could not work. In this case, many of the prognosis tracks are to help the patient and their family become more comfortable and understand what will happen.

Associated conditions

• Brain injury caused by trauma
  • Bleeding into the brain (intracerebral hemorrhage)
  • Bleeding into the space around the brain (subarachnoid hemorrhage)
  • Blood clot inside the skull causing pressure on brain (subdural hematoma)
  • Concussion
• Breathing conditions
  • Low oxygen in the body (hypoxia)
  • High carbon dioxide levels in the body (hypercapnia)
• Cardiovascular disorders
  • Abnormal heart rhythm (arrhythmias)
  • Brain injury due to high blood pressure (hypertensive brain injury)
  • Dementia due to many strokes (multi-infarct dementia)
  • Heart infections (endocarditis, myocarditis)
  • Stroke
  • Transient ischemic attack (TIA)
• Degenerative disorders
  • Alzheimer's disease (also called senile dementia, Alzheimer's type)
  • Creutzfeldt–Jakob disease
  • Diffuse Lewy Body disease
  • Huntington's disease
  • Multiple sclerosis
  • Normal pressure hydrocephalus
  • Parkinson's disease
  • Pick's disease
• Dementia due to metabolic causes
• Drug and alcohol-related conditions
  • Alcohol withdrawal state
  • Intoxication from drug or alcohol use
  • Wernicke-Korsakoff syndrome (a long-term effect of excessive alcohol consumption or malnutrition)
  • Withdrawal from drugs (especially sedative-hypnotics and corticosteroids)
• Infections
  • Any sudden onset (acute) or long-term (chronic) infection
  • Blood poisoning (sepsis)
  • Brain infection (encephalitis)
  • Meningitis (infection of the lining of the brain and spinal cord)
  • Prion infections such as mad cow disease
  • Late-stage syphilis
• Other medical disorders
  • Cancer
  • Kidney disease
  • Liver disease
  • Thyroid disease (high or low)
  • Vitamin deficiency (B1, B12, or folate)
• Lithium toxicity can cause permanent organic brain damage
• Accumulation of heavy metals in the brains
  • Aluminum
  • Mercury poisoning