LISH MAN ’S
Organic Psychiatry
Lishman's Organic Psychiatry: A Textbook of Neuropsychiatry, Fourth Edition Anthony S. David, Simon Fleminger, Michael D. Kopelman, Simon Lovestone and John D.C. Mellers
© 2009 Anthony David, Simon Fleminger, Michael Kopelman, Simon Lovestone, John Mellers and William A Lishman ISBN: 978-1-405-11860-6
,LI SH MAN ’ S
Organic Psychiatry
A Textbook of Neuropsychiatry
Anthony S. David
Simon Fleminger
Michael D. Kopelman
Simon Lovestone
John D.C. Mellers
foreword by
Marshal Folstein
F OU R TH ED ITION
A John Wiley & Sons, Ltd., Publication
,© This edition first published 1987, 1988 by William Alwyn Lishman, 1978 Blackwell Science Ltd,
2009 Anthony David, Simon Fleminger, Michael Kopelman, Simon Lovestone, John Mellers and
William A Lishman
Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing
program has been merged with Wiley’s global Scientific, Technical and Medical business to form
Wiley-Blackwell.
Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex,
PO19 8SQ, UK
Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at www.
wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance
with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the
prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print
may not be available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All
brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product
or vendor mentioned in this book. This publication is designed to provide accurate and
authoritative information in regard to the subject matter covered. It is sold on the understanding
that the publisher is not engaged in rendering professional services. If professional advice or other
expert assistance is required, the services of a competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or
promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The
publisher and the author make no representations or warranties with respect to the accuracy or
completeness of the contents of this work and specifically disclaim all warranties, including
without limitation any implied warranties of fitness for a particular purpose. In view of ongoing
research, equipment modifications, changes in governmental regulations, and the constant flow of
information relating to the use of medicines, equipment, and devices, the reader is urged to review
and evaluate the information provided in the package insert or instructions for each medicine,
equipment, or device for, among other things, any changes in the instructions or indication of usage
and for added warnings and precautions. Readers should consult with a specialist where
appropriate. The fact that an organization or Website is referred to in this work as a citation and/or
a potential source of further information does not mean that the author or the publisher endorses
the information the organization or Website may provide or recommendations it may make.
Further, readers should be aware that Internet Websites listed in this work may have changed or
disappeared between when this work was written and when it is read. No warranty may be created
or extended by any promotional statements for this work. Neither the publisher nor the author
shall be liable for any damages arising herefrom.
Library of Congress Cataloging-in-Publication Data
Lishman’s organic psychiatry : a textbook of neuropsychiatry / Anthony David . . . [et al.]. – 4th ed.
p. ; cm.
Rev. ed. of: Organic psychiatry / William Alwyn Lishman. 3rd. ed. 1998.
Includes bibliographical references and index.
ISBN: 978-1-4051-1860-6
1. Neuropsychiatry. 2. Neurobehavioral disorders–Etiology.
[DNLM: 1. Brain Diseases–complications. 2. Delirium, Dementia, Amnestic, Cognitive
Disorders–etiology. 3. Neurobehavioral Manifestations. WM 220 L7692 2006] I. Title: Organic
psychiatry. II. David, Anthony S. III. Lishman, William Alwyn. Organic psychiatry.
RC386.L57 2006
616.89′071–dc22
2006005025
A catalogue record for this book is available from the British Library.
Set in 9.25/12 pt Palatino by SNP Best-set Typesetter Ltd., Hong Kong
Printed in Singapore by Fabulous Printers Pte Ltd.
1 2009
, Contents
Contributor List, vi 6 Epilepsy, 309
Foreword, vii 7 Intracranial Infections, 397
Preface to the First Edition, ix 8 Cerebrovascular Disorders, 473
Preface to the Fourth Edition, xi 9 Alzheimer’s Disease and Other Dementias (Including
Pseudodementias), 543
Part 1 | Principles 10 Endocrine Diseases and Metabolic Disorders, 617
1 Basic Concepts in Neuropsychiatry, 3 11 Addictive and Toxic Disorders, 689
2 Neuropsychology in Relation to Psychiatry, 29 12 Movement Disorders, 745
3 Clinical Assessment, 103 13 Sleep Disorders, 817
14 Other Disorders of the Nervous System, 845
Part 2 | Specific disorders
4 Head Injury, 167 Index, 907
5 Cerebral Tumours, 281 Colour plates are found facing p. 468
v
Organic Psychiatry
Lishman's Organic Psychiatry: A Textbook of Neuropsychiatry, Fourth Edition Anthony S. David, Simon Fleminger, Michael D. Kopelman, Simon Lovestone and John D.C. Mellers
© 2009 Anthony David, Simon Fleminger, Michael Kopelman, Simon Lovestone, John Mellers and William A Lishman ISBN: 978-1-405-11860-6
,LI SH MAN ’ S
Organic Psychiatry
A Textbook of Neuropsychiatry
Anthony S. David
Simon Fleminger
Michael D. Kopelman
Simon Lovestone
John D.C. Mellers
foreword by
Marshal Folstein
F OU R TH ED ITION
A John Wiley & Sons, Ltd., Publication
,© This edition first published 1987, 1988 by William Alwyn Lishman, 1978 Blackwell Science Ltd,
2009 Anthony David, Simon Fleminger, Michael Kopelman, Simon Lovestone, John Mellers and
William A Lishman
Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing
program has been merged with Wiley’s global Scientific, Technical and Medical business to form
Wiley-Blackwell.
Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex,
PO19 8SQ, UK
Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at www.
wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance
with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the
prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print
may not be available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All
brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product
or vendor mentioned in this book. This publication is designed to provide accurate and
authoritative information in regard to the subject matter covered. It is sold on the understanding
that the publisher is not engaged in rendering professional services. If professional advice or other
expert assistance is required, the services of a competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or
promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The
publisher and the author make no representations or warranties with respect to the accuracy or
completeness of the contents of this work and specifically disclaim all warranties, including
without limitation any implied warranties of fitness for a particular purpose. In view of ongoing
research, equipment modifications, changes in governmental regulations, and the constant flow of
information relating to the use of medicines, equipment, and devices, the reader is urged to review
and evaluate the information provided in the package insert or instructions for each medicine,
equipment, or device for, among other things, any changes in the instructions or indication of usage
and for added warnings and precautions. Readers should consult with a specialist where
appropriate. The fact that an organization or Website is referred to in this work as a citation and/or
a potential source of further information does not mean that the author or the publisher endorses
the information the organization or Website may provide or recommendations it may make.
Further, readers should be aware that Internet Websites listed in this work may have changed or
disappeared between when this work was written and when it is read. No warranty may be created
or extended by any promotional statements for this work. Neither the publisher nor the author
shall be liable for any damages arising herefrom.
Library of Congress Cataloging-in-Publication Data
Lishman’s organic psychiatry : a textbook of neuropsychiatry / Anthony David . . . [et al.]. – 4th ed.
p. ; cm.
Rev. ed. of: Organic psychiatry / William Alwyn Lishman. 3rd. ed. 1998.
Includes bibliographical references and index.
ISBN: 978-1-4051-1860-6
1. Neuropsychiatry. 2. Neurobehavioral disorders–Etiology.
[DNLM: 1. Brain Diseases–complications. 2. Delirium, Dementia, Amnestic, Cognitive
Disorders–etiology. 3. Neurobehavioral Manifestations. WM 220 L7692 2006] I. Title: Organic
psychiatry. II. David, Anthony S. III. Lishman, William Alwyn. Organic psychiatry.
RC386.L57 2006
616.89′071–dc22
2006005025
A catalogue record for this book is available from the British Library.
Set in 9.25/12 pt Palatino by SNP Best-set Typesetter Ltd., Hong Kong
Printed in Singapore by Fabulous Printers Pte Ltd.
1 2009
, Contents
Contributor List, vi 6 Epilepsy, 309
Foreword, vii 7 Intracranial Infections, 397
Preface to the First Edition, ix 8 Cerebrovascular Disorders, 473
Preface to the Fourth Edition, xi 9 Alzheimer’s Disease and Other Dementias (Including
Pseudodementias), 543
Part 1 | Principles 10 Endocrine Diseases and Metabolic Disorders, 617
1 Basic Concepts in Neuropsychiatry, 3 11 Addictive and Toxic Disorders, 689
2 Neuropsychology in Relation to Psychiatry, 29 12 Movement Disorders, 745
3 Clinical Assessment, 103 13 Sleep Disorders, 817
14 Other Disorders of the Nervous System, 845
Part 2 | Specific disorders
4 Head Injury, 167 Index, 907
5 Cerebral Tumours, 281 Colour plates are found facing p. 468
v
