Organic vs Psychiatric Question

[clement]

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MS 3 here...Today's GR lecture was given by a neurologist. One slide was approached in which the neurologist was discussing hallucinations and said, "...With visual hallucinations, think organic...With auditory hallucinations, think psychiatric."
Now I admit I was half dozing and I think he was talking in the context of ICU settings, but I was too shy to ask him to clarify. What is your take on this?

 

[masterofmonkeys]

MS 3 here...Today's GR lecture was given by a neurologist. One slide was approached in which the neurologist was discussing hallucinations and said, "...With visual hallucinations, think organic...With auditory hallucinations, think psychiatric."
Now I admit I was half dozing and I think he was talking in the context of ICU settings, but I was too shy to ask him to clarify. What is your take on this?

It's basically right. Alcohol is of course at the top of the list when it comes to visual hallucinations. But parkinson's/lewy body disease, seizures, delirium. are the first things that come to mind if we're not dealing with alcohol related phenomena. Your radar should also go off for conversion disorder and secondary gain type stuff. Which I've seen as well.

 

[Doc Samson]

It's a rough guide. VH are more typically associated with non-primary-psychiatric illness, but it's not a hard and fast rule by any stretch of the imagination. Causes of VH include seizures, tumors, lhermitte's syndrome, anton's syndrome, migraine, and of course delirium/DTs as mentioned by MoM. I object a little to the characterization of psychiatric illness as "non-organic."

 

[masterofmonkeys]

I object a little to the characterization of psychiatric illness as "non-organic."

I thought I'd let you handle that issue this time lol

 

[Doc Samson]

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2660156&blobtype=pdf