In fact, they are more common than many well-known structural vestibular disorders. Brandt, in Handbook of Clinical Neurology, 2016 Abstractįunctional and psychiatric disorders that cause vestibular symptoms (i.e., vertigo, unsteadiness, and dizziness) are common. This differentiates them from the final broad categories of psychiatric disorder, personality disorder and mental retardation. The other important thing to note about functional illnesses is that they are illnesses that is, they represent a change from what is normal for the patient. This is not to underestimate the importance of psychological and social factors but should serve as a reminder that biological processes are also important in functional illness. The main difference from organic disorder is that the underlying cause of functional psychiatric illness has not yet been determined, largely because it is so difficult to investigate brain function during life. In other words, it would be equivalent to functional psychiatric illness. Therefore, cardiac failure would be an illness defined in syndromal terms but the underlying tissue pathology would not be known. The association with symptoms such as chest pain and signs such as heart murmurs would give clues to the aetiology but it would be impossible to determine it for sure. The presence of oedema in some cases would suggest that excess water was a problem and so treatment with venesection (drainage of blood) or diuretics might be developed. Cardiac failure would remain a common clinical problem but its aetiology would be unknown. Imagine, though, if it had never been possible to investigate the internal workings of the human body. Therefore, while the terms organic and functional are useful for classification, they can be misleading about aetiology, as the following example shows.Ĭardiac failure is a syndrome, the causes of which are known. In fact, there is increasing evidence that structural, neurochemical and neuroendocrine abnormalities of the brain are important factors in some functional illnesses. The danger of making such a distinction is that it encourages the belief that functional illness is the result only of psychological and social factors. It remains a useful way of classifying psychiatric disorders. The distinction between organic and functional conditions was made at a time when body and mind were considered separate entities and, in that context, it was perfectly valid. In this case, a crude definition would be that functional illness is psychiatric illness without a ‘physical’ cause. Lesley Stevens MB BS FRCPsych, Ian Rodin BM MRCPsych, in Psychiatry (Second Edition), 2011 Functional illnessįunctional illness is the term given to all psychiatric illness other than organic disorder.
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