What is not organic psychosis

Organic psychosis (acute)

Acute organic psychosis (Acute exogenous psychosis): Physically justifiable (organic) psychosis, which usually regresses within days to weeks as the causal organic disease improves. Acute organic psychoses can occur after traumatic brain injuries, strokes, poisoning, dehydration, anesthesia, high fever or epileptic seizures.

The similarity between physically justifiable mental disorders and other most serious mental illnesses, e.g. Depression or schizophrenia is sometimes great. Therefore, in the case of many severe mental illnesses, an acute organic psychosis must first be ruled out.

The distinction between an acute and an (incipient) chronic organic psychosis is not always immediately possible, especially since the transitions are fluid.

Leading complaints

  • If hallucinations, delusions or fear are pronounced - communication with the patient becomes impossible.
  • Loss of memory and orientation: The patient does not know where he is for a short time, suffers from misjudgments (e.g. he sees something different in objects).
  • Fear and excitement.

When to the doctor

Immediately, because acute organic psychoses are medical emergencies.

The illness

Acute exogenous psychosis is always based on a serious disorder of the brain, either through a skull injury (even a brief concussion is enough to trigger), a tumor, meningitis or a stroke. But general diseases such as liver, thyroid and kidney diseases, very high fever or the anesthetic gases from an operation can disrupt brain functions.

However, an acute organic psychosis can also develop into a chronic organic psychosis. This happens especially when the cause such as B. alcohol addiction is not eliminated.

A special case of acute organic psychosis is the less severe one Continuity syndrome. Here, clouding of consciousness, hallucinations and delusions are absent or only weakly pronounced. Instead, the focus is on symptoms such as forgetfulness, slow reactions or dizziness.

Another special case is that Delirium (Delirium), a state of acute mental confusion that is life threatening. The early warning signs are insomnia, anxiety, and tremors; Delirium often sets in with a seizure and is characterized by disorientation, clouding of consciousness, impaired memory, lively hallucinations, anxious restlessness, pronounced tremors (tremor) or panic attacks in which the patient screams and lashes out. The symptoms are aggravated at night. Alcoholics who have been drinking very heavily for a long time are particularly affected, because delirium is typical in withdrawal of alcohol-dependent patients. However, it can also occur during an episode of very serious abuse. Immediate emergency care is urgently needed. If left untreated, the alcohol withdrawal delirium is fatal in 15–20%. When treated, the mortality drops to 1–5%.

The doctor does that

Neuroleptics are given against psychotic symptoms, i.e. delusions and hallucinations, and tranquilizers are given against overexcitation. Very aggressive and extremely restless sufferers can also be restrained for a short time (in bed) - for example if there is a risk that someone who has recently been operated on will jump out of bed or an alcoholic attacks the nursing staff in the delirium of withdrawal. The focus of the therapy is on the treatment of the underlying organic disease.

Your pharmacy recommends

It is important not to leave the person affected alone. Avoidance of noise and crowds, adequate lighting, familiar faces and communication favoring clear and simple words counteract fears and disorientation. After the event, those affected are exhausted for a while and need rest.

Further information

  • J. F. Spittler: Acute organic psychoses. Disturbances in consciousness and consciousness. Pabst Science Publishers, 2001. A critical look at the smooth transition between "normal" and "crazy".


Dr. med. Arne Schäffler, Gisela Finke in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 14:54

Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.