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In the past these conditions were classified under the heading organic mental or organic brain disorders. Traditionally those disorders had an identifiable pathological condition such as brain tumor, cerebrovascular disease or drug intoxication
Brain disorders with no generally accepted basis (such as depression) were called functional disorders This century-old distinction between organic & functional disorders is outdated & has been deleted from the nomenclature. The only unbiased conclusion to be made from evaluation of the available data is that every psychiatric disorder has an organic ( biological or chemical) component
Because of this reassessment of the data, the concept of functional disorders has been determined to be misleading, & the term functional & organic are not used in that context in DSM-IVTR
DELIRIUM
1. general medical condition, e.g : infection 2.substance induced, e.g :cocaine,opioid,phencyclidine 3. multiple causes,e.g. head trauma & kidney disease 4.delirium not otherwised specified, e.g. : sleep deprivation
In DSM-IV-TR delirium is characterized by a disturbance of consciousness & a change in cognition that developed over a short time Delirium has a sudden onset, a brief & fluctuating course, & rapid improvement when the causative factor is identified & eliminated, but each of these characteristic features can vary in individual patients
DEMENTIA
Multiple cognitive defects that include impairment in memory, without impairment in consciousness.
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ETIOLOGY
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Miscroscopic findings : senile plaques, neurofibrillary tangles, neuronal loss,synaptic loss, & granulovascular degeneration of the neuron
Neurofibrillary tangles (NT) are composed of cytoskletal elements, primarily phosphorylated tau protein, although other cytoskletal proteins are also present NT is also occur in Down syndrome, dementia pugilistica, Parkinson, brains of normal people as they age
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people with 1 copy of the gene E4 have AD 3 X more frequently than no E4 People with 2 E4 : have AD 8 X more frequently than no E4 E4 is found in persons without dementia & not found in all cases of dementia
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AMNESTIC DISORDERS
Acquired impaired ability to learn & recall new information or inability to recall previously learn knowledge or past events Amnestic disorders are secondary syndrome caused by systemic medical or primary cerebral disease, substance use disorders or medication adverse effects.
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