Today ' s Treatment Psychological Medicine Organic Illness

Amnesia, dementia, and confusion have areas of overlap that can be ciarified in the individual by a full history from patient and relatives, along with the observations and comments of trained staff who have been looking after the patient. The information that is needed can be summarized thus: (a) Orientation in time and space. (b) Memory for recent and past personal events. (c) Memory for recent and past general events. (d) Attitude and behaviour in the ward or clinic. (e) Mood, activities, sleep pattern. Confusional states are characterized by loss of immediate memory, which in an unfamiliar setting inevitably involves disorientation. After recovery there is no recollection of the episode, and overall mental function may prove to be normal. It is, then, an acute reversible situation. Dementia is a composite of intellectual decline, loss of memory, and personality deterioration. It is usually, but not always, of slow onset and represents severe, generalized, cortical damage. Amnesia does not necessarily mean that dementia is present; some quite specific acute amnesic syndromes occur in a relatively pure form.