DSM-III and the diagnosis of organic mental disorders

Among the many emergency patients who complain of behavioral symptoms, a significant proportion suffer from a physical illness manifesting as an organic mental disorder. Dementia and delirium should be considered in the presence of an impairment of orientation, alertness, or cognition. Effort is required to remain aware of the organic differential diagnoses of hallucinatory, delusional, amnestic, and affective disorders or of personality changes not associated with overt changes of sensorium or cognitive abilities. We review the DSM-III classification of organic mental disorders published by the American Psychiatric Association, and consider the usefulness of historical data, mental status examination, physical examination, laboratory investigations, and hospitalization in the differentiation of organic from functional disorders.