Organic

Organic Mental Disorders as Hypothetical Pathogenetic Processes
Lindqvist G, Malmgren H. Organic Mental Disorders as Hypothetical Pathogenetic Processes. Acta Psychiatr Scand 1993: 88: Suppl 373: 5-17. Abstract — A new diagnostic system for organic psychiatry is presented. We first define “organic psychiatry”, and then give the theoretical basis for conceiving organic-psychiatric disorders interms of hypothetical psychopathogenetic processes, HPP:s. Such hypothetical disorders are not strictly identical to the clusters of symptoms in which they typically manifest themselves, since the symptoms may be concealed or modified by intervening factors in non-typical circumstances and/or in the simultaneous presence of several disorders. The six basic disorders in our system areAstheno-Emotional Disorder (AED), Somnolence-Sopor-Coma Disorder (SSCD), Hallucination-CoenestopathyDepersonalisation Disorder (HCDD), Confusional Disorder (CD), EmotionalMotivational Blunting Disorder (EMD) and Korsakoff’s Amnestic Disorder (KAD). We describe their usual etiologies, their typical symptoms and course, and some forms of interaction between them.
G. Lindqvist1, H. Malmgren 2 1 Department ofNeurosurgery, Sahlgren Hospital, Göteborg, Sweden 2 Department of Philosophy, University of Göteborg, Sweden Keywords: Classification, Diagnosis, Organic mental disorders, Organic psychiatry, Psychopathogenetic theory Helge Malmgren, Associate Professor, Department of Philosophy, University of Göteborg, S-412 98 Göteborg, Sweden

Introduction
In this work we want to present a new classificatory anddiagnostic system for organic psychiatry. We believe that both theoretically and practically, this system has considerable advantages over the presently available alternatives1. We consistently use diagnoses referring not to directly observable symptoms as such, but to hypothetical pathogenetic processes (HPP:s). The classificatory categories in our system have mostly been derived from traditional(mainly central European) psychiatric diagnoses, but have been modified according to our experience and systematized according to logical and semantical considerations.

Organic psychiatry
We define organic psychiatry in two different ways depending on whether we use the concept (A) with reference to practical clinical work, or (B) in a nosological context. The concept of an organic cause (C)of a symptom is of course also central to our concerns. A. Organic psychiatry as a practical, clinical field can be delimited as the psychiatric management of
1For a comprehensive presentation of the system cf (1).

cases in which well-defined somatic diseases or injuries have brought about mental symptoms through a disturbance of cerebral function. However, the content of the term can also becaptured by means of an enumeration of examples. Among the somatic diseases and injuries which we meet in organic psychiatry are, then, such intracranially localized conditions as traumatic brain injuries, brain tumors, intracranial bleedings and thromboses, hydrocephalus, degenerative brain diseases and intracranial infections; but also states resulting from diseases which are primarily localizedin other parts of the body but secondarily disturb brain function, as for example endocrinopathies, systemic infections, cardiac arrest, attempts at suicide by hanging and other causes of anoxia, and toxic states as for example eclampsia and uremia. This means that a major share of the psychiatric consultations at different somatic wards — for example in endocrinological and neurosurgicaldepartments — fall within organic psychiatry, but so do many cases which the psychiatrist primarily sees at the psychiatric ward or in a psychiatric outpatient setting. One must not overemphasize the need for an exact delimitation of organic psychiatry as a practical field. In clinical practice, organic psychiatry should always be an integral part of general psychiatry. The practitioner of organic...