ABSTRACT
The psychological presentations of illness comprise the following: anxiety, including phobic anxiety and obsessional fears; depression, neurotic, psychotic or pseudo-depression; hydrochondriasis; mania and euphoria; hallucinations and delusions; acute, subacute and chronic organic brain syndromes. In tertiary syphilis, depression is the usual presentation. Any chronic systemic disease is of importance, as are anaesthetic difficulties if this is a post-anaesthetic presentation. Anxiety is a common reaction to any disorder, depending on its meaning to the patient. Minor anxiety or depression is common currency, and frank mental illness is no rarity in association with physical disorders. Drug-related depression may also illuminate the pathology of the disorder. Depression follows the onset of various organic illnesses. P. B. Storey found affective disorder following subarachnoid haemorrhage, and Trimble and Cummings described depression in patients in whom haemorrhage into the upper brainstem had disrupted adrenergic and serotoninergic neurotransmitter pathways. Functional psychiatric disorders, auditory hallucinations are the most frequent, usually voices.
