1. Organic mental disorders are caused by physical damage or disease in the brain that results in impaired mental functioning. Common causes include head injuries, strokes, substance abuse, and neurological conditions. 2. Delirium is a type of acute organic mental disorder characterized by a rapid decline in attention, awareness, and cognition. It is often precipitated by medical illnesses, infections, medication side effects, or physical restraints in vulnerable populations like the elderly. 3. Symptoms of delirium include impaired concentration, altered consciousness, cognitive changes, as well as behavioral disturbances like restlessness, hallucinations, or withdrawal. Diagnosis involves assessing mental status, physical examination, and testing to identify underlying medical causes.

1. R.RUPPAMERCY
M.Sc NURSINGII YEAR
MENTALHEALTHNURSING

2. WHAT IS ORGANIC
MENTAL
DISORDER????

3. INTRODUCTION
An organic mental disorder (OMD), also known as
organic brain syndrome, decreased mental function due
to a medical or physical disease of the brain.
The brain cells could be damaged due to a physical
injury (a severe blow to the head, stroke, chemical and
toxic exposures, organic brain disease, substance abuse,
etc.) or due to psycho-social factors like severe
deprivation, physical or mental abuse, and severe
psychological trauma

4. CLASSIFICATION OF ORGANIC MENTAL
DISORDERS – ICD 10
F00: Dementia in Alzheimer’s disease.
F01: vascular dementia.
F02: Dementia in other diseases classified
elsewhere
F03: Unspecified dementia
F04: Organic amnestic syndrome.
F05: Delirium.
F06: Mental disorders due to brain damage,
dysfunction and physical disease
F07: Personality and behavioral disorders due to
brain disease, damage and dysfunction.

5. TYPES OF ORGANIC BRAIN DISORDER
 Delirium (Acute brain syndrome)
 Dementia (chronic brain syndrome)
 Amnestic (due to - may or may not
organic or non – organic )
WHAT IS THE DIFFERENCE ?

6. DELIRIUM
INTRODUCTION
 de (away from, out of) + Lira (the earth thrown up
between two furrows) means out of tract
 Acute organic brain syndrome
 Delirium is a syndrome, not a disease.
 Once the acute episode has remitted, the premorbid
level of functioning is reached again, with personality
reappearing intact.

7. DEFINITION
 Serious disturbance in mental abilities that results
in confused thinking and reduced awareness of
surrounding. It is also known as acute confusional
state.
 THREE C’S
Rapid onset of
 impairment and fluctuation in CONCENTRATION.
 Altered CONSCIOUSNESS.
 Impaired COGNITION.

10. TYPES OF DELIRIUM
 Hypoactive delirium.
This may include inactivity or reduced motor
activity, sluggishness, abnormal drowsiness.
 Hyperactive delirium.
This may include restlessness , agitation, rapid
mood changes or hallucinations.
 Mixed delirium.
This includes both hyperactive and hypoactive
symptoms. The person may quickly switch back
from hyperactive to hypoactive states.

11. Risk factors
1. Predisposing risk factors
 Age > 70 yrs
 Sex : male > women
Brain disorders such as
 Dementia,
 Stroke or parkinson's disease
 Previous delirium episodes
 Visual or hearing impairment
 Having multiple medical problems

12. Risk factors
2. Precipitating factors
 Use of Physical restraint
 Use of indwelling catheter
 Adding three or more medications
 pain
 Surgery
 Anaesthesia and hypoxia
 Malnutrition and dehydration

13. CAUSES????

14. SIGNS & SYMPTOMS
The clinical hallmarks of delirium
are decreased awareness, a change
in baseline cognition and behavior.
It begins over a few hours or a few
days.

15. REDUCED AWARENESS OF THE
ENVIRONMENT
 An inability to stay focused on a topic or to
switch topics.
 Getting stuck on an idea rather than
responding to question or conversation.
 Being easily destructed
 Being withdrawn

16. POOR THINKING SKILLS (COGNITIVE
IMPAIRMENTS)
 Poor memory, particularly of recent events.
 Disorientation. (E.g.) not knowing where you are or who
you are.
 Difficulty speaking or recalling words.
 Trouble understanding speech
 Difficulty reading or writing

17. BEHAVIOR CHANGES
This may include
 Hallucinations
 Restlessness, agitation
 Calling out, making other sounds
 Being quiet and withdrawn — especially in
older adults
 Slowed movement or lethargy
 Disturbed sleep habits
 Reversal of night-day sleep-wake cycle

18. EMOTIONAL DISTURBANCES
This may appear as:
 Anxiety, fear or paranoia
 Depression
 Irritability or anger
 A sense of feeling elated (euphoria)
 Apathy
 Rapid and unpredictable mood shifts
 Personality changes

19. DIAGNOSIS
 Mental status Examination.
To assess orientation, attention and thinking.
 Physical and neurological Examination:
 Physical Examination: To check for signs of health
problems and underlying disease.
 Neurological Examination: Check for vision, balance
Co-ordination and reflexes.
 Other test: Blood and urine to check for electrolyte
imbalance.
 Brain Imaging.
 Rating scale

20. MANAGEMENT
Treat the underlying causes or triggers. (Eg.)
 Stopping use of particular medication.
 Care for metabolic imbalance
 Treating Infection.
 Vitamins- Patient with alcoholism & malnutrition prone
for thiamine, B12 deficiency which can cause delirium.
 Medication
 Antipsychotic-To treat agitation, hallucination and to
improve sensory problem.
 (Eg) Haloperidol, Risperidone, Olanzapine, quetiapine
 Benzodiazepines

21. NURSING MANAGEMENT
• Assess the level of anxiety to intervene
before violence occurs.
• Provide an appropriate environment.
• Promote patients safety.
• Ask assistance from others when needed.
• Stay calm and reassure patients.
• Medicate or restrain patients as prescribed.
• Observe suicide precautions.
• Teach relaxation exercises.

22. CONTD…
Medications
 Talk with the doctor about avoiding or minimizing the
use of drugs that may trigger delirium.
 Certain medications may be needed to control pain
that's causing delirium.
 Fluid and nutrition should be given carefully because
the patient may be unwilling or physically unable to
maintain a balanced intake.
 For the patient suspected of having alcohol toxicity or
alcohol withdrawal, therapy should include
multivitamins, especially thiamine

23. SUPPORTIVE THERAPY
To Prevent Complications by
o Protecting the Airway.
o Providing adequate Nutrition.
o Assisting with movement.
o Treating pain.
o Addressing Incontinence
o Avoiding use of physical restraints
o Avoiding changes in surrounding.
o Encouraging the family members to involve
in the care.

24. PREVENTION
 Having a clock and calendar nearby
 Having lots of lighting during the day
 Limiting medicines that may cause delirium, or any
extra medicines that are not needed
 Drinking plenty of water and other fluids
 Trying to walk or at least sit in a chair daily
 Reporting to doctors any symptoms of an infection
(cough, fever, pain, shortness for breath)
 Family involvement in the patient’s treatment

25. RECAPITULATE…..

26. THANK YOU….