Five patients had normal pressure hydrocephalus (NPH) within the context of a psychiatric dimension. The incidence of NPH is highest in the older age group. Psychiatric sequelae can be the predominant, as well as initial, clinical manifestation of this syndrome. Normal pressure hydrocephalus is an organic brain syndrome that is potentially reversible by a neurosurgical shunting procedure. The mental status of the patient and the necessity for the inclusion of NPH in the differential diagnosis are important.