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Amnestic Disorders
Second Year Psychiatry
Cognition
The mental process of knowing.
Includes awareness, perception,
Cognitive Disorders
Disruptions in the acts and
Historical Background
Used to be classified under
Historical Background
In DSM-V, under Neurocognitive
Disorders
Delirium retained
Dementia replace with major and
minor neurocognitive disorder
Emphasis on decline in functioning
rather than memory disturbance
Areas of Primary
Disturbance
Delirium level of consciousness
Areas of Primary
Disturbance
Dementia impairment in
Delirium
Acute onset of disturbance in
Epidemiology Delirium
Higher prevalence and incidence
in
Elderly
Multiple medical problems
Hospitalized patients especially
critically ill patients
Terminally ill patients
Clinical Features of
Delirium
Primary feature -diminished clarity of
Clinical Features of
Delirium
Develops over a short period of
Causes of Delirium
Infections
Metabolic and endocrine abnormalities
Intracranial states
Hypoperfusion states
Substance intoxication/withdrawal
Postoperative states
Sensory and environmental changes
Evaluation of Delirium
Evaluation of Delirium
Evaluation of Delirium
Management of Delirium
Find cause/s
Correct or eliminate cause/s
Supportive therapy,
environmental control
Pharmacologic agents
Dementia
A progressive impairment of
DSM-IV-TR Classification of
Dementia
Alzheimers Type
Vascular Dementia
Due to Other General Medical
Conditions
Substance Induced Persisting
Dementia
Dementia Due to Multiple Etiologies
Not Otherwise Specified
Epidemiology of
Dementia
65 years and older 5%
85 years and older 20% to 40
%
General medical outpatient
15% to 20%
Chronic care facilities 50%
Potentially Reversible
Causes
of Dementia
Structural central nervous
system factors
Vascular factors
Head trauma
Subdural hematoma
Normal-pressure hydrocephalus
Multiple sclerosis
Major depression
Substance dependence
Systemic/metabolic factors /infectious diseases
Hypothyroidism
Hypercalcemia
Hypoglycemia
Thiamine, niacin, B12 deficiency
Renal failure
Hepatic failure
Medications
CNS infections
Clinical Features of
Dementia
Multiple cognitive deficits
Clinical Features of
Dementia
Decline from a higher level of
functioning
Gradual onset and continuing
cognitive decline
Does not occur exclusively in the
course of a delirium
Evaluation of Dementia
possible cause
Environmental manipulation to
reorient patient
Multiple interventions involving
family and patient
Pharmacological management when
appropriate
prognosis
-etiology
-time span between onset and start of
treatment
-presence of comorbid psychiatric
symptoms
-level of psychosocial support
Amnestic Disorder
characterized by a lost of
DSM-IN-TR Classification of
Amnestic Disorder
amnestic disorder due to a general
medical condition
substance-induced persisting
amnestic disorder
not otherwise specified
Causes of Amnestic
Disorder
Reference
Sadock BJ, Sadock, VA. . In Kaplan and
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