Differential diagnosis of acute psychoorganic syndrome

Medical Review (Med. pregled), 2025, 61(6), 58-62.

G. Onchev

Department of Psychiatry and Medical Psychology, Medical University – Sofia

Abstract. The differential diagnosis of acute psycho-organic syndrome, which is common in inten- sive care units and always indicates severe somatic decompensation, is presented. The main disturbances associated with qualitative changes in consciousness are examined from a phenomenological perspective and are differentiated from similar manifestations in primary (“endogenous”) psychoses. Key to understanding the organic condition is not the cross-sectional clinical picture, but rather the sequence of changes in the clinical presentations over time. Practical guidelines are provided for the differential diagnosis between acute and chronic psycho-organic syndrome and for delirium in various physical conditions. The disturbances are illustrated with a clinical case.

Key words: differential diagnosis, acute psycho-organic syndrome, delirium, phenomenological psychopathology

Address for correspondence: Prof. Georgi Onchev, MD, e-mail: georgi.onchev@gmail.com