Organic delirious states and other psychiatric disorders: lessons for the hepatologists

Hepatic encephalopathy (HE) is characterized by a wide variety of neuropsychiatric symptoms, and from a psychiatric perspective its nosological status calls for clarification. According to the ICD-10 classification, it can be classified as delirium due to overt HE's core symptom of clouding of consciousness in increasing degrees. Minimal/covert HE with impairment of neurocognitive function is more difficult to classify and could correspond to Mild Cognitive Impairment or mild degrees of dementia. However, the advantages of current psychiatric nosology is the possibility of thorough characterization of both dispositional and premorbid psychopathology as well as psychiatric morbidity induced by liverdiseases or even treatment. A future closer collaboration between hepatologists and psychiatrists is advocated.