ABNORMAL MENTAL STATE - ORGANIC versus FUNCTIONAL

See also Medical Clearance of psychiatric patients

There are three main distinguishable syndromes of disturbed behaviour of which the causes and treatment are all different:

  DELIRIUM ACUTE PSYCHOSIS DEMENTIA
Age Variable < 40 y.o. > 40 y.o.
Onset Acute Acute Chronic
Course Fluctuating, Transient Recurrent, Relapsing Chronic
Past Psychiatric history +/- + (unless first presentation)
Vital signs Abnormal, Diaphoresis Normal Normal
Neurological exam Abnormal Normal Usually normal
MENTAL STATE
  • Behaviour

 

 Variable
Asterixis/Tremor		 Variable Apraxic
  • Conversation/Thought

 

 Slow/Pressured/
Incoherent/Poorly organised delusions		 Systematised delusions Aphasic (if severe)
  • Perception

 

 Visual/Tactile/Auditory hallucinations Auditory hallucinations Agnosia
COGNITION
  • Orientation
 Disorientated Usually orientated Chronically disorientated
  • Attention/Concentration
 Decreased Disorganised/Distracted
Other Poor memory/abstraction/
planning/ organising