Organic Psychosis Research Articles

Psychiatric diagnoses made by the agecat system in residents of local authority homes for the elderly: Outcome and diagnostic stability after four years

AbstractEighty‐six residents of 12 local authority homes for the elderly were interviewed with the Geriatric Mental State (GMS) in 1985/6 after having been classed as depressed by a screening interview. The data so gathered were analysed by the computerized diagnostic program AGECAT in order to derive psychiatric diagnoses for these residents. All were traced after four years; 61 were dead. The 25 survivors were reinterviewed and given a second AGECAT diagnosis. In 1985/6 70 of the 86 examined were ‘diagnostic cases’ of psychiatric disorder. After four years 22 of the 25 survivors were classed as diagnostic cases. AGECAT diagnoses of organic psychosis were stable over four years within this population though the majority of subjects so diagnosed died within four years. Cases of depression had a more varied prognosis, with death, continunce as cases of depression or progression to organic psychosis being the most common outcomes. Recovery from any class of AGECAT disorder was an uncommon event.

The concept of consciousness from the neuropsychiatric and interdisciplinary viewpoint

In German neuropsychiatric literature there is an established tradition of viewing the disturbance of consciousness as a leading symptom of the acute, potentially reversible organic psychoses. Following the late H. H. Wieck acute organic psychoses which are characterized by a disturbance of wakefulness (syndromes of somnolence, sopor, coma), have to be distinguished from those with preserved wakefulness, which he called 'Durchgangssyndrom' (e.g. amnesic syndrome with affective lability). These two syndromes have found their way into textbooks and everyday language in medicine as 'disturbance of consciousness'. But neurology and psychiatry are developing in different directions. Furthermore classical phenomenological psychopathology is not a numerative science and consciousness is still under the persisting eliminative verdict of behaviorism. During the last decades consciousness and the psychopathology of acute organic psychoses have been subject to methodological reflection only with the aim of elaborating quantitative scales. In philosophy and psychology there has been a development towards a new impartiality about consciousness during the same time. The biological sciences have acquired more knowledge about cerebral functions with respect to conscious mental processes and between these sciences a fruitful cooperation has evolved from this. The different views of consciousness in relevant neighbouring sciences are looked at from two main points of view. Following classical descriptive tradition are: philosophy (Bunge, Seifert, Hastedt), philosophically oriented psychiatry (Jaspers, Ey), descriptive psychology (Deleay/Pichot), and the post-behaviorist psychology (Hilgard, Mandler, Natsoulas). On the other hand the neurobiologically oriented sciences: clinical neuropsychology (Mesulam, Kolb/Wishaw, Poeck, Stuss, Shallice), neurophysiology (Brain, Goldman-Rakic, Creutzfeldt, Roland), and neurophilosophy (Churchland, Oeser). These more recent developments can contribute to a more actual sight of psychopathology of consciousness in neurology and psychiatry.

A study on HTP organic signs

A special version of the House-Tree-Person (H-T-P) technique was developed to differentiate organic psychosis from other disorders. H-T-P data of 126 psychiatric inpatients, including 16 patients with organic psychoses, 50 schizophrenics, 50 borderlines and 10 patients with other psychoses, were evaluated for the presence or absence of 29 possible features of houses, trees and persons. These features included those common to all three objects, as well as those specific to each object. Results for patients with organic psychoses were compared with those of patients with other disorders. The comparison disclosed that seven of the original 29 H-T-P features had diagnostical discrimination among treatment groups, giving higher H-T-P organic scores.

White matter lesions in psychiatric patients: a retrospective MRI study

T2-weighted MRI scans of psychiatric patients with at least one white matter lesion (WML) were compared to 83 non-psychiatric controls with respect to WML number and distribution. MANOVA results in significant effects for sex, age and patient group with respect to WML number. In the psychiatric patients, infratentorial WML prevailed in organic psychoses. WML number was positively correlated with age with the exception of rith temporal lobe WML. Based on WML spatial distribution, four patient clusters were found. Clusters with widely distributed WML comprised older patients with late onset of illness; right frontal and temporal WML were associated with mania, euphoria and unstable mood.

Midline anomalies and organic psychosis: congenital or degenerative? A cross-sectional study of 62 patients with Andermann syndrome

Brain alterations have been sought since the beginning of the century to explain the ‘dementia’ of dementia præcox. Kraepelin suggested in 1913 that it might have its internal origins in early childhood, while Southard (1915) considered likely a congenital or early acquired basis for the development of the disease. Afterwards, degenerative processes were described for decades until neurodevelopmental theories emerged recently (Lewis, 1988).Using pneumoencephalography, Jacobi and Winkler (1927) first reported that some patients with schizophrenia presented enlarged ventricles. Johnstone et al (1976, 1978), in CT-scan studies, observed an increase in mean lateral ventricular size in a group of institutionalized schizophrenic patients. This finding has been replicated by other studies (Weinberger et al, 1983) but challenged by others (Gluck et al, 1980; Jernigan et al, 1982).

Inpatient Sociodemographic and Diagnostic Study from a Psychiatric Hospital in Libya

Sociodemographic and diagnostic characteristics of 1009 patients admitted to the Psychiatry Hospital, Benghazi (Libya) in one calendar year are reported. Five hundred and four (50%) were 'first admission' cases. There were an average of 2.05 admissions for each 'readmission' case. Eighty nine percent of patients were of Libyan origin, of whom 62% were males; 66% were between 15-34 years of age, 37% were married, 28% were unemployed and 16% were in military service. ICD-9 schizophrenic psychosis was the commonest diagnosis (39%), followed by affective psychosis (17%), neurotic disorders (12%), organic psychosis (8%) and acute psychosis (7%). Neurotic depression was the commonest type of neurotic disorder and antisocial personality was the commonest among personality disorders. Relationship of sociodemographic variables with major diagnostic categories was studied in Libyan patients. Sociodemographic profiles of 'first admission' and 'readmission' cases of Libyan origin were also compared. These findings are discussed in relation to the sociocultural context.

The Concept of Delirium in German-Speaking Psychiatry

The concept of delirium has gone through a major transformation in German-speaking psychiatry. In the traditional German-speaking literature, the concept was defined in very broad terms, partially corresponding to our present concept of psychosis. Today, the term is usually interpreted in terms of Bonhoeffer's “acute exogenous reaction types” which are classified under the reversible psychoses with “lowered consciousness”; the reversible (acute) organic psychoses are subdivided into those with and those without disturbance of consciousness.

Capgras delusion in the elderly: The evidence for a possible organic origin

AbstractWe report the case of a 77‐year‐old right‐handed woman with early dementia of the Alzheimer type who developed the paranoid delusion that her husband had been replaced by an imposter (Capgras phenomenon). Her CT scan showed mild generalized cortical atrophy of the parieto‐occipital cortex. We reviewed the cases of 45 patients over 60 years who showed a Capgras delusion. Twenty‐five suffered from dementia or other chronic organic mental disorders, 20 were paranoid, 14 were at least moderatley depressed and 12 disorientated. CT scans (reported in 17 cases) showed global cerebral atrophy in 12 patients. Right hemisphere infarcts have been described in two elderly patients with Capgras delusions. Focal brain atrophy in Alzheimer type dementia has hitherto not been reported in association with this delusional symptom. We conclude from these observations that marked cerebral lesions and specific neuropsychological deficits are not required for the development of the Capgras phenomenon, which can occur in various functional or organic psychosis of old age.

Psychiatric, neurological and medical aspects of misidentification syndromes: a review of 260 cases

Two hundred and sixty case reports of misidentification syndromes were evaluated. One hundred and seventy-four patients had a Capgras syndrome misidentifying other persons, 18 a Fregoli syndrome, 11 intermetamorphosis, 17 reduplicative paramnesia and the rest had other forms or combinations of mistaken identification. Schizophrenia (127 cases), mostly of paranoid type, affective disorder (29), and organic mental syndromes including dementia (46) were the most common diagnoses in patients who misidentified others or themselves. The patients with reduplicative paramnesia more frequently suffered from head trauma or cerebral infarction and showed more features of right hemisphere lesions on neuropsychological testing or CT scan than the patients with other misidentification syndromes. Forty-one case-reports implicated underlying medical conditions. Forty-six of the patients were reported to show violent behaviour. The misidentification of persons can be a manifestation of any organic or functional psychosis, but the misidentification of place is frequently associated with neurological diseases, predominantly of the right hemisphere. Misidentification syndromes show a great degree of overlap and do not represent distinctive syndromes nor can they be regarded as an expression of a particular disorder. These patients deserve special diagnostic and therapeutic attention because of the possible underlying disorders and their potentially dangerous behaviour.

Prevalence of Delusional Jealousy in Different Psychiatric Disorders

The prevalence of delusional jealousy in 8134 psychiatric in-patients was 1.1%. Delusions of jealousy were most frequent in organic psychoses (7.0%), paranoid disorders (6.7%), alcohol psychosis (5.6%) and schizophrenia (2.5%), while in affective disorder delusions of jealousy could be found in only 0.1%. Because schizophrenia and affective disorder were the most common diagnoses, most patients with delusions of jealousy were schizophrenics. In schizophrenia, women were more likely to suffer from delusional jealousy, while in alcohol psychosis, men were more likely than women to suffer from delusional jealousy.

Acute Psychosis: Functional Versus Organic

Acute psychosis is a true emergency and is a manifestation of multiple organic and functional disorders. The emergency medicine physician's role in dealing with the acutely psychotic patient is to control the patient's behavior, to delineate the etiology of the psychosis, and to provide appropriate initial treatment and disposition. When making initial contact with the psychotic patient, behavioral control can be accomplished through supportive, physical, or pharmacologic interventions. Judicious use of rapid tranquilization permits rapid control of these patients when supportive and other nonpharmacologic therapies fail. Initial examination is directed at identifying immediate life-threatening organic disorders and promptly treating them. Historical data, mental status examination, physical examination, and appropriate radiologic and laboratory investigations give information that assist in delineating functional from organic psychosis. Most acute organic psychoses, with the exception of some drug intoxications that clear in the Emergency Department, require medical or surgical admission. Acute functional psychotic patients who are a danger to themselves or others, who are without a reliable social support system, or who present with their first psychotic episode require admission to the psychiatric service for further evaluation and treatment.

Psychiatric Manifestation of Vitamin B-12 Deficiency: An Update

Psychiatric manifestations of vitamin B-12 deficiency are reviewed from 1986 to the present. Specific clinical entities reviewed include depression, organic psychosis, obsessive-compulsive disorder, childhood manifestations and dementia. We recommend that consideration be given to B-12 deficiency as an etiological factor in some cases of depression, organic psychosis, certain childhood disorders and dementia. Routine screening of people overage 65 is addressed.

Mental Dysfunction and Cobalamin Deficiency

To the Editor .—Carmel 1 has described a series of pernicious anemia cases defined by a low serum cobalamin level and either an abnormal Schilling test result, absence of intrinsic factor, or presence of anti—intrinsic factor antibodies. A number of these cases displayed only neurologic or neuropsychiatric symptoms, with normal hematologic parameters. In another recent study, Lindenbaum et al 2 described similar observations. We agree with these authors and feel that the neuropsychiatric aspects of cobalamin deficiency need to be emphasized. Cobalamin deficiency may present as organic psychosis with neither spinal cord nor hematologic abnormalities. 3,4 We have studied two patients who presented with organic psychosis and low vitamin B 12 levels in the absence of any neurologic or hematologic abnormalities. One patient showed diffuse slowing on electroencephalographic examination and mild cerebral dysfunction on neuropsychologic testing; both the electroencephalographic and the neuropsychiatric test results became normal after vitamin B 12

Organic Affective Psychosis Associated with the Routine Use of Non-prescription Cold Preparations

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.

Characteristics of Male and Female Schizophrenics at First Admission

Based on information from a case register, patient age and diagnosis at first admission are analysed in a Croatian cohort of schizophrenics first admitted in 1972 and followed up through the register for 12 years. Diagnosis was analysed on the same basis and over the same period. Although the male and female differences in incidence rates for schizophrenia were not large, hospital incidence rates in younger age groups were higher in males. Males were also more commonly diagnosed as schizophrenic at first admission, females more frequently receiving diagnoses of affective psychosis and other organic psychosis, except for alcohol-induced psychosis.

Neurosarkoidose

Observation of neurosarcoidosis in a thirty-year-old black female characterised predominantly by bilateral facial nerve paralysis gave rise to a review of literature since 1978 and also to a comparison with an early study in 1963. As described 1963 the clinical picture is characterized by increased protein content of the CSF (33.8%), facial nerve paresis (25.5%), pleocytosis (23%), diabetes insipidus (21%), hemiparesis (17.2%), organic psychosis (16.9%), papilloedema (15.5%), ataxia (13%), convulsive seizures (12.5%), optic atrophy (12.5%), loss of hearing (12.2%), nystagmus (8.6%) and numerous other symptoms more rarely found. This corresponds to the symptoms of chronic basal meningitis with an infiltration in the neighbouring structures of brain and less frequently the spinal cord. In only 58.7% of the cases (presumably at the onset of sarcoidosis) was the bronchial tract (or the lungs) affected, in 11.5% the skin or the eyes. Although the clinical picture is clear enough the etiology has yet to be determined. Evidence of a pathogen or a pathogenic agent (analogous to berylliosis) has never been established to date. On the other hand there are some indications of a disturbance in the immune system, perhaps of a particular genetic foundation since sarcoidosis strikes black patients with conspicuous frequency. There exist more cases in one family. Exceeding expected random distribution, many patients have the HLA-Factor B 8 (on the chromosome 6) and DR 3. The Kveim-Test was in 71 cases positive, in 12 cases negative. The possibilities of carrying out studies of CSF - analogous to the studies of bronchial lavage - in the most cases of neurosarcoidosis have not been exhausted as to determine the activity of the T-lymphocytes, the interleucines, the angiotensin-converting enzyme while the Gallium 67 scintigraphy and other methods to determine the non-specific activity of the inflammation. The efficiency of the treatment with corticosteroids (Prednison or Triamcinolonacetonid) depends of the phase of the inflammatory process. 12% of the registered cases died.

Vitamin B 12 and folate status in acute geropsychiatric inpatients: Affective and cognitive characteristics of a vitamin nondeficient population

This chart review study examined the serum vitamin B 12 and folate status of 102 geriatric patients newly admitted to a private psychiatric hospital. Only 3.7% were B 12 deficient and 1.3% were folate deficient; 4% were anemic. Nevertheless, those with below-median values of both vitamins had significantly lower Mini-Mental State scores than patients higher in one or both vitamins. Patients with “organic psychosis” with a negative family history for psychiatric disorder had significantly lower B 12 levels than those with a positive family history. In major depression, folate levels correlated negatively with age at onset of psychiatric illness and length of hospitalization. These data suggest that (1) biochemically interrelated vitamins such as B 12 and folate may exert both a separate and a concomitant influence on affect and cognitio; (2) poorer vitamin status may contribute to certain geropsychiatric disorders that begin at a later age and lack a familial predisposition.

Bullet in the brain: a case of organic psychosis

Bullet in the brain: a case of organic psychosis

Bullet in the Brain: A Case of Organic Psychosis

Back to table of contents Previous article ArticleNo AccessBullet in the Brain: A Case of Organic PsychosisE. CAMERON RITCHIE, RALPH PRIMELO, and ALAN Q. RADKEE. CAMERON RITCHIESearch for more papers by this author, RALPH PRIMELOSearch for more papers by this author, and ALAN Q. RADKESearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/jnp.1.4.449-aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Journal of Neuropsychiatry and Clinical Neurosciences $35.00 Add to cart PPV Articles - Journal of Neuropsychiatry and Clinical Neurosciences Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byPsychiatric Clinics of North America, Vol. 37, No. 1Psychotic Disorder Due to Traumatic Brain Injury: Analysis of Case Studies in the LiteratureDaryl Fujii, Ph.D., and Daniel C. Fujii1 July 2012 | The Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 24, No. 3Advances in Psychiatric Treatment, Vol. 5, No. 4 Volume 1Issue 4 November 1989Pages 449-a-451 Metrics PDF download History Published online 1 April 2006 Published in print 1 November 1989

The impact of molecular genetics on our understanding of the psychoses.

Studies demonstrating the linkage to separate chromosomal locations of Alzheimer's disease, manic depression, and schizophrenia require re-evaluation of our ideas of their genetic aetiology. This article reviews the findings, and explores the increasing contribution of the 'new genetics' to our understanding of the organic and functional psychoses.