Characteristics of patients with organic brain syndromes : A cross-sectional 2-year follow-up study in Kuala Lumpur, Malaysia

Prem K Chandrasekaran,Stephen T Jambunathan,Nor Z Zainal

doi:10.1186/1744-859x-4-9

Prem K Chandrasekaran, Stephen T Jambunathan + Show 1 more

Open Access

https://doi.org/10.1186/1744-859x-4-9

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Abstract

BackgroundOrganic Brain Syndromes (OBS) are often missed in clinical practice. Determining their varied presentations may help in earlier detection, better management, and, assessing prognosis and outcome. We described the in-patient referrals of patients suffering from the psychiatric effects of organic states and compared the symptomatology and mortality between those with the Acute and Chronic varieties.Methods59 patients referred to our Consultation-Liaison (C-L) Psychiatry services and given a clinical diagnosis of OBS were selected over a 6-month period. Psychiatric and cognitive abnormalities and treatment regimes were recorded and fatality rates determined. Information regarding their condition 24 months after their index hospitalization was recorded. All data were entered into a proforma and analyzed after exclusion.ResultsThe mean duration of detecting the symptoms by the physician was 3.52 days. The presence of a premorbid psychiatric illness had no influence on the clinical presentation but did on the mortality of patients with OBS (p = 0.029).Patients with the Acute syndrome had significantly more symptom resolution as compared to those with the Chronic syndrome (p = 0.001) but mortalityrates did not differ. Elderly patients and those with symptom resolution upon discharge did not show statistically significant higher mortality rates. The most popular combination of treatment was that of a low-dose neuroleptic and a benzodiazepine (34.7%). The need for maintenance treatment was not significantly different in any group, even in those with a past history of a functional disorder.ConclusionOther than the Acute group having a significantly better outcome in terms of symptom resolution, our findings suggest that there was no significant difference in the clinical presentation between those with Acute or Chronic OBS. Mortality-wise, there was also no difference between the Acute and Chronic syndromes, nor was there any difference between the elderly and the younger group. There was also no significant difference in the need for continued treatment in both groups.

Highlights

Organic Brain Syndromes (OBS) are often missed in clinical practice
Other than the Acute group having a significantly better outcome in terms of symptom resolution, our findings suggest that there was no significant difference in the clinical presentation between those with Acute or Chronic OBS
There was no significant difference in the need for continued treatment in both groups

Summary

Introduction

Organic Brain Syndromes (OBS) are often missed in clinical practice. Determining their varied presentations may help in earlier detection, better management, and, assessing prognosis and outcome. Diseases of the brain are frequently manifested by psychiatric symptomatology, a condition conventionally termed 'Organic Brain Syndrome'. One justification for the use of the term is as a kind of abbreviated phrase to refer to the full range of abnormal mental symptoms commonly associated with definable neurological disease [1]. It should be stressed that OBS are defined in psychiatric terms and not in neurologic terms. They are purely descriptive and carry no specific aetiologic implications [2].

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