ON THE MEANING OF THE TERM ORGANIC IN PSY CHIATRY TODAY

The distinction between ''organic'' and ''functional'' mental disorder s can be traced back to the medicine of antiquity. As a classificatory concept however it was incorporated into psychiatric nosology only at the beginning of this century. The empirical content of the term ''or ganic'' is historically variable. It encompasses mental disorders whos e presence can be explained by an independently demonstrable somatic f inding. The demonstrability of a somatic cause, however, does not mean that it completely determines the psychological changes, nor does it imply that mental disorders without demonstrable somatic correlates ar e devoid of any physical underpinning. The phenomenology of organic me ntal disorders is by no means uniform but can be broken down into seve ral patterns or syndromes which differ according to their heuristic va lue. The outstanding weakness of the term ''organic'' is the implicit dichotomy of aetiological factors. It will not be resolved by the sema ntic shift from ''functional-organic'' to ''primary-secondary'' in DSM -IV A dimensional rather than categorical concept of aetiology would b e more appropriate to the current knowledge on the origin and maintena nce of mental disorders, and to therapeutic procedures.