When confronted with a patient with an alteration in mental status following surgery, the physician must consider both organic and psychosocial causes and their synergistic interactions. A careful medical assessment will rule out metabolic disorders, sepsis, cardiopulmonary complications, and adverse drug effects. A mental status examination and psychiatric history from the patient and family will identify psychosocial determinants. Simultaneous treatment of the organic and psychosocial components is essential if the physician hopes to provide the best patient care and maximize the likelihood of recovery.