Characterizing organic delusional syndrome.

Abstract

To the Editor.— In their recent article, Cornelius and colleagues 1 have advanced the description of the phenomena and associated clinical findings in the organic delusional syndrome. Given the syndrome's clinical complexities in terms of etiologic heterogeneity and unknown pathophysiologic findings, research is begging for basic, precise, and accurate clinical description to give organization, coherence, and consistency to our observations in this syndrome. Indeed, the entire area of those organic brain syndromes without significant cognitive impairment is fraught with semantic and nosologic difficulties even prior to the accurate and consistent clinical phenomenologic description. These issues confront the DSM-IV work group on Organic Mental Disorders. 2 A problem in the article has to do with a lack of nosologic discrimination and preciseness. All the clinical descriptors of acquired intellectual impairment, poor concentration, and impaired sensorium indicate cognitive impairment. As used in the study, DSM-III 3 and DSM-III-R 4 criteria emphasize that