Organic psychosyndrome

As Organic psychosyndrome all psychological changes that can be traced back to an organic disease, usually of the brain, are called. The old term "organic brain psychosyndrome" is hardly used any more. The organic psychosyndrome - or the physically justifiable psychosis - is generally divided into an acute and chronic form.

What is Organic Psychosyndrome?

The first unspecific signs of an organic psychosyndrome can be memory disorders, lack of interest, abnormal behavior and decreased physical performance.
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Doctors speak of an organic psychosyndrome when a psychological change (e.g. delirium, impaired consciousness, dementia, confusion, etc.) is based on an organic cause, e.g. a brain tumor, cerebral haemorrhage, encephalitis, or if this occurs as a result of a traumatic brain injury.

Not only different diseases of the brain can precede the organic psychosyndrome, a variety of other physical illnesses can also be causally responsible. The organic psychosyndrome, as an organically induced form, must be strictly differentiated from other types of psychological change: from the endogenous psychoses, i.e. psychoses justifiable by predisposition, such as depression, mania or schizophrenia, and exogenous psychoses, i.e. mental disorders caused by external factors.

Furthermore, in the organic psychosyndrome, a distinction is made between the acute organic psychosyndrome and the acute organic psychosyndrome. In principle, age and cerebral or physical extent play an important role in the prognosis and the probable course of this disease or this syndrome. Due to the wide range of possible causes, a diagnosis that is as precise as possible is a basic requirement for a long-term effective therapy for organic psychosyndrome.

causes

As diverse as the manifestations of an organic psychosyndrome are, the triggering causes can be just as diverse. When dementia occurs, for example, different brain diseases can be present, such as a stroke (apoplexy), a traumatic brain injury, a brain tumor, encephalitis or meningitis, a cerebral haemorrhage, but also epilepsy, among other things.

As far as non-cerebral causes are concerned, a wide variety of metabolic diseases can also be responsible for an organic psychosyndrome: These include hypoglycaemia or 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.

But also poisoning (intoxication) through medication (e.g. antidepressants, neuroleptics, antihistamines), drugs or alcohol as well as the withdrawal symptoms can play a role. Likewise, severe dehydration and the associated disruption of the water-salt balance in the body (desiccosis) or a lack of oxygen (hypoxia) can lead to an organic psychosyndrome.

Symptoms, ailments & signs

The first unspecific signs of an organic psychosyndrome can be memory disorders, lack of interest, abnormal behavior and decreased physical performance. Anxiety often occurs, creativity and enthusiasm are lost. Affected people become indifferent to themselves and their environment, neglect personal hygiene and food intake.

Acute organic psychosyndrome can develop within hours. It is characterized by a clouding of consciousness that is characterized by disorientation, fear or delusions. Hallucinations usually occur in the form of acoustic perceptions such as hearing voices or optical illusions, sensory illusions in the area of ​​smelling, tasting, feeling or body perception are more rarely observed.

Delirium is usually associated with disorientation, hyperactivity, tremors, circulatory disorders and excessive sweating; a hypoactive form of delirium rarely occurs. Amnesia is characterized by a memory impairment in which a certain period of time has been erased from the person's memory. Orientation disorders can affect time, place, people or the current situation of the sick person.

The mind can be affected in a variety of ways: Slowed thinking, flight of ideas, erratic thinking or a narrowing of the scope of thinking occur. Mood swings that suggest depression or bipolar disorder are also typical. The chronic organic psychosyndrome develops insidiously and is associated with the progressive loss of mental abilities, personality changes and behavioral disorders.

Diagnosis & course

As far as the course and diagnosis of the organic psychosyndrome are concerned, due to the large number of manifestations, an exact specification in individual cases is necessary. As far as the extent and the basic course are concerned, a distinction is made between two types of organic psychosyndrome.

Acute organic psychosyndrome includes: the affective syndrome with mood changes, the amnesiac syndrome with memory disturbance and loss, the twilight state with severe drowsiness and thought disorders, the delirium in the form of excitation, palpitations, restlessness and hallucinations, the hallucinosis, also with hallucinations, the isolated disorder of consciousness with severe drowsiness, the aspontaneous syndrome with drive disorder despite wakefulness up to a coma, as well as a general state of confusion with disorientation.

These acute organic psychosyndromes are seen as reversible or curable, but - depending on the cause - can also become chronic. The acute form is offset by the chronic organic psychosyndrome: This usually occurs due to permanent damage to the brain. In this case, dementia with a dwindling intellectual memory and thinking performance is often diagnosed, or also a frontal brain syndrome or Korsakov syndrome (local brain syndrome) as well as, for example, mutism or an apallic syndrome (so-called defect syndromes, e.g. after coma). The hypersomnia syndrome (addiction to sleep) and the neurasthenic syndrome with nerve and brain weakness are also part of the chronic organic psychosyndrome.

The chronic organic psychosyndromes can, depending on the cause, age and extent, be stable or progressive (progressive). In order to predict a possible course or to initiate therapeutic steps, a comprehensive and precise diagnosis is therefore in the foreground in 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 (electro-encephalogram), a CCT (brain computed tomography), a measurement of intracranial pressure and, if necessary, a CSF puncture.

In order to arrive at a diagnosis that is as precise as possible, we also look for emotional behavior problems and changes (delusion, exhibitionism, depression, tantrums, mood swings, etc.), as well as for thought and memory disorders, anxiety, orientation problems, lack of interest, fatigue, problems with food consumption or personal hygiene, drive disorders, etc., but also after general physical symptoms such as dizziness, sweating or nausea.

Complications

In this syndrome, patients suffer from a number of different changes in the psyche. This usually leads to psychosis and further psychological upsets or depression. In many cases, the patients also suffer from social complaints and can no longer maintain their social contacts. Inner restlessness or memory disorders also occur and in many cases are accompanied by a racing heart or sweating.

Concentration or orientation disorders also occur with this syndrome and have a very negative effect on the quality of life of the person affected. In many cases, hallucinations or increased irritability of the person concerned also occur. In many cases, parents or relatives are severely affected by the symptoms of this syndrome.

In the worst case, the affected person completely loses consciousness and falls into a coma. Treatment for this condition is usually based on its cause. However, a positive course cannot be guaranteed in every case. The use of psychotropic drugs can lead to various side effects for those affected and significantly reduce the quality of life.

When should you go to the doctor?

If people show any abnormalities in their personality, they should consult a doctor. Disorders of consciousness, a clouding of consciousness, confusion or a peculiarity of the memory activity must be examined and treated. A doctor is needed in the event of gaps in memory or the inability to store knowledge and events in memory. A low mood, depressed state, or listlessness are signs of an existing health disorder. A doctor should be consulted so that the cause can be clarified.

Failure to meet day-to-day obligations, delusional beliefs, or a highly euphoric mood give cause for concern. Fear, behavioral problems, profuse sweating or hallucinations are further indications of a mental illness. Often the person affected lacks the necessary insight into the disease. Therefore, the support and assistance of people in the social environment is necessary. A relationship of trust must be established with the person concerned so that he or she can consult a doctor.

In severe cases, a medical officer must be appointed. Orientation disorders or circulatory irregularities are complaints that need to be treated. Sensory delusions are characteristic of an organic psychosyndrome. A doctor's visit should be arranged as soon as possible so that the symptoms do not increase. Reduced well-being, inner restlessness and apathy should be presented to a doctor.

Treatment & Therapy

Individual treatment depends on the particular diagnosis. Of course, one of the most important therapeutic measures is treating the underlying organic disease as best and as far as 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) may be possible therapy options. In the case of a new chronic organic psychosyndrome, rehabilitation is the starting point for medical treatment.

If no causal cure is found, the symptoms, such as Hallucinations, states of restlessness or depression can be alleviated as best as possible with medication. In many cases - especially in the case of damage to the brain - a complete recovery is rather unlikely, so that it is precisely here that efforts must be made to improve the symptoms.

In the case of purely physical, especially acute organic psychosyndromes, on the other hand, very good treatment results can be achieved once the organic causes have been eliminated. This is e.g. the case with metabolic diseases or a disturbance of the electrolyte balance. In some cases, the therapeutic approach and success also depend on the patient's compliance, e.g.when alcohol abuse is causally responsible for the organic psychosyndrome.

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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.

Especially in the case of an acute organic psychosyndrome, the chances of recovery are described as very good. With this disease, it is important to find out quickly what exactly caused the deficit. Electrolyte disturbances as well as hypernatremia, hyponatrimae and traumatic brain injury require their own individual treatment. If the course is milder, medication or antibiotics can provide quick relief. Serious illnesses may also require surgery to remove infected tissue. If 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 main aim of treatment is to reduce the symptoms of the body and the psyche and thus improve the patient's quality of life. Even if there are good treatment options available nowadays, a positive course of the organic psychosyndrome cannot be guaranteed in every case. Regular preventive care and rapid treatment of the cause can significantly improve the prognosis of the disease.

prevention

A prevention or prevention is hardly possible due to the large symptomatic and causal range. A healthy, balanced lifestyle - also and especially with regard to mental balance - and the avoidance of alcohol and drugs can at least protect against an organic psychosyndrome caused by physical deficiency or pleasure poisons.

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 to prevent unfavorable processes. In addition, the same applies to organic psychosyndrome: The earlier a diagnosis is made and effective therapy can be started, the better the chances of recovery.

Aftercare

In the case of organic psychosyndrome, follow-up care should not be forgotten. This depends on the cause and underlying disease that led to the organic psychosyndrome. Follow-up examinations can identify and address the patient's psychosocial problems at an early stage. The doctor and therapist provide the patient with competent advice.

He recognizes the need for therapeutic approaches, self-help and other aids at an early stage as part of the aftercare. In addition, regional rehabilitation opportunities can be arranged. If patients join the aftercare networks for organic psychosyndrome and use them, further inpatient stays can be shortened or completely prevented.

If the patient is well accompanied by the follow-up care, he can learn more about himself and his illness through self-reflection. The perception changes. For some patients, this may be more promising than years of psychotherapy. However, a broad timeframe is required for follow-up treatments. Not every treatment is entirely promising to the full extent. Frequently, new approaches are necessary by the doctor and therapist.

Long-term therapy in a psychotherapeutic group can also be helpful for patients with organic psychosyndrome. Exchanging ideas with group members is very promising and makes sense here. This promotes self-reflection and strengthens the tendency towards mental equilibrium.

You can do that yourself

Due to the complaints and immense impairment of the brain functions, the disease does not offer the patient any possibilities for self-help. Usually, the person concerned is dependent on daily support from other people and cannot take care of themselves. A hospital stay is often associated with the disease, as relatives are overwhelmed by the situation. If family members take care of the person affected, they must inform themselves comprehensively about the appearance of the mental disorder and its consequences.

The organic psychosyndrome can lead to unsocial behavior on the part of the person concerned. People from the social environment urgently need to be informed about the disease and its consequences. It is necessary to deal with the patient in an understanding manner so that the situation does not worsen or contacts are broken off. Since disorientation and confusion show up as further complaints, one should try to face the daily challenges with calm and patience. The more stable the social environment and the more regulated the daily routine, the better it is for the patient.

Avoid hectic rush, stress and excitement. The everyday processes have to be organized and taken over by others, as the person concerned is not able to do so. Illusions and hallucinations often occur. In these moments, any provocation should be avoided.