ORGANIC PSYCHOSES

In traditional psychiatric language, organic psychoses are psychotic states—whether acute (like delirium tremens ) or chronic (like the senile dementias)—having a known, identified biological substrate (histological, toxic, and so on) that is directly related to the pathology. They are opposed to the functional psychoses (acute, like delusional fits, or chronic, like schizophrenia).

From the beginning of the nineteenth century, the term psychosis has been used to describe all pathologies, whatever their pathogenesis, that combine a loss of reality (deficiency in the reality-apprehension functions) with the creation of an alternative reality (hallucinations and delusional ideas). Initially, the term organic referred to "organ" and designated those psychoses where the symptoms are due to organ damage (the language apparatus in the dementias, for example), as opposed to functional psychoses—for example, in schizophrenia, also called dementia praecox, disorders of language are not caused by an organ being affected, but by a problem of function. Gradually, the term organic came to be used for all pathologies with a biological substrate, and was thus opposed to psychogenic. As of 2005, the opposition between organic psychoses and functional psychoses has fallen into disuse.

Freud never adopted this terminology, doubtless owing to the originality of his approach, which established concepts (such as the instincts, the libido, the economic theory) that make it possible to conceive of the biological and the mental in conjunction. Thus, he did not hesitate to speak of "toxic" etiology with regard to certain types of melancholia and hallucinatory psychoses, which in his view referred to anomalies in the level and/or the distribution of the libido, and which was in no way in opposition to the demonstration of psychological mechanisms.

Vassilis Kapsambelis

See also: Pscyhogenesis/organogenesis.