[Acute and subacute organic psychoses with altered consciousness. Attempt at classifying severity]

We have retrospectively investigated 71 patients with ICD-9 diagnoses 293.0 or 293.1, who were treated in our clinic in 1987, with respect to the maximum severity of altered consciousness. On the basis of an available neurological grading into "clouding of consciousness", "confusional state", "delirium", "stupor", and "coma", and from knowledge of the underlying somatic disease, we have developed prognostic criteria: Disorders of heart and circulation associated with acute organic mental disorder (with altered consciousness) carry a fair prognosis for recovery of the mental disorder in approximately two-thirds of all patients affected, even in advanced age. The same statement is valid with respect to drug-induced acute organic mental disorders, whereas most cases of cerebrovascular disorders with mental disturbances proceed to chronic forms of organic mental disorder. We believe that the clinical descriptive terms referred to above allow easy grading of states of acutely/subacutely altered consciousness, thereby providing prognostic criteria for the course of the disease.