Confusion

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Confusion
Confused child.jpg
A child confused by the camera
Specialty Psychiatry

In Psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion" [1] is often used interchangeably with delirium [2] in the International Statistical Classification of Diseases and Related Health Problems and the Medical Subject Headings publications to describe the pathology. These refer to the loss of orientation, or the ability to place oneself correctly in the world by time, location and personal identity. Mental confusion is sometimes accompanied by disordered consciousness (the loss of linear thinking) and memory loss (the inability to correctly recall previous events or learn new material). [3]

Contents

Etymology

The word confusion derives from the Latin word, confundo, which means "confuse, mix, blend, pour together, disorder, embroil."

Causes

Confusion may result from drug side effects or from a relatively sudden brain dysfunction. Acute confusion is often called delirium (or "acute confusional state"), [4] although delirium often includes a much broader array of disorders than simple confusion. These disorders include the inability to focus attention; various impairments in awareness, and temporal or spatial dis-orientation. Mental confusion can result from chronic organic brain pathologies, such as dementia, [5] as well.

Other

Differential diagnosis

The most common causes of drug induced acute confusion are dopaminergic drugs (used for the treatment of Parkinson's disease), diuretics, tricyclic, tetracyclic antidepressants and benzodiazepines or alcohol. The elderly, and especially those with pre-existing dementia, are most at risk for drug induced acute confusional states. [8] New research is finding a link between vitamin D deficiency and cognitive impairment (which includes "foggy brain"). [9]

See also

Related Research Articles

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Delirium is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days. As a syndrome, delirium presents with disturbances in attention, awareness, and higher-order cognition. People with delirium may experience other neuropsychiatric disturbances including changes in psychomotor activity, disrupted sleep-wake cycle, emotional disturbances, disturbances of consciousness, or, altered state of consciousness, as well as perceptual disturbances, although these features are not required for diagnosis.

<span class="mw-page-title-main">Vascular dementia</span> Dementia resulting from stroke

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<span class="mw-page-title-main">Wernicke–Korsakoff syndrome</span> Combined presence of Wernickes encephalopathy (WE) and Korsakoffs syndrome

Wernicke-Korsakoff syndrome (WKS) is the combined presence of Wernicke encephalopathy (WE) and alcoholic Korsakoff syndrome. Due to the close relationship between these two disorders, people with either are usually diagnosed with WKS as a single syndrome. It mainly causes vision changes, ataxia and impaired memory.

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<span class="mw-page-title-main">Organic brain syndrome</span> Disorder of mental function whose cause is alleged to be known as physiological

Organic brain syndrome, also known as organic brain disease, organic brain damage, organic brain disorder (OBD), organic mental syndrome, or organic mental disorder, refers to any syndrome or disorder of mental function whose cause is alleged to be known as organic (physiologic) rather than purely of the mind. These names are older and nearly obsolete general terms from psychiatry, referring to many physical disorders that cause impaired mental function. They are meant to exclude psychiatric disorders. Originally, the term was created to distinguish physical causes of mental impairment from psychiatric disorders, but during the era when this distinction was drawn, not enough was known about brain science for this cause-based classification to be more than educated guesswork labeled with misplaced certainty, which is why it has been deemphasized in current medicine. While mental or behavioural abnormalities related to the dysfunction can be permanent, treating the disease early may prevent permanent damage in addition to fully restoring mental functions. An organic cause to brain dysfunction is suspected when there is no indication of a clearly defined psychiatric or "inorganic" cause, such as a mood disorder.

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<span class="mw-page-title-main">Alcohol withdrawal syndrome</span> Medical condition

Alcohol withdrawal syndrome (AWS) is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive use. Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever. More severe symptoms may include seizures, and delirium tremens (DTs); which can be fatal in untreated patients. Symptoms start at around 6 hours after the last drink. Peak incidence of seizures occurs at 24 to 36 hours and peak incidence of delirium tremens is at 48 to 72 hours.

Sundowning, or sundown syndrome, is a neurological phenomenon wherein people with delirium or some form of dementia experience increased confusion and restlessness beginning in the late afternoon and early evening. It is most commonly associated with Alzheimer's disease but is also found in those with other forms of dementia. The term sundowning was coined by nurse Lois K. Evans in 1987 due to the association between the person's increased confusion and the setting of the sun.

<span class="mw-page-title-main">Neurological disorder</span> Any disorder of the nervous system

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Amnesia is a deficit in memory caused by brain damage or brain diseases, but it can also be temporarily caused by the use of various sedative and hypnotic drugs. The memory can be either wholly or partially lost due to the extent of damage that is caused.

<span class="mw-page-title-main">Nutritional neuroscience</span> Scientific discipline

Nutritional neuroscience is the scientific discipline that studies the effects various components of the diet such as minerals, vitamins, protein, carbohydrates, fats, dietary supplements, synthetic hormones, and food additives have on neurochemistry, neurobiology, behavior, and cognition.

References

  1. Confusion Definition on Oxford Dictionaries.
  2. Delirium Archived 13 May 2019 at the Wayback Machine , Symptom Finder online.
  3. confusion in TheFreeDictionary, citing: Dorland's Medical Dictionary for Health Consumers; 2007; Saunders.
  4. Acute Confusional State; Dr. Gurvinder Rull; patient.info; Document ID/Version/Reference: 1714/22/bgp2104; updated: 13 Jan 2009; accessed: when?.
  5. Ried, S.; Gutzmann, H. (1 August 2003). "Das Pflegephänomen "Chronische Verwirrtheit" im Kontext der Diagnose "Demenz"". Zeitschrift für Gerontologie und Geriatrie. 36 (4): 297–302. doi:10.1007/s00391-003-0129-6. ISSN   0948-6704. PMID   12937935.
  6. Broderick, E. D.; Metheny, H.; Crosby, B. (2021). "StatPearls". StatPearls. PMID   30521219.
  7. "Confusion: Symptoms, Signs, Causes & Treatment". MedicineNet. Retrieved 3 February 2016.
  8. Hufschmidt, A.; Shabarin, V.; Zimmer, T. (December 2009). "Drug-induced confusional states: the usual suspects?". Acta Neurologica Scandinavica . 120 (6): 436–8. doi: 10.1111/j.1600-0404.2009.01174.x . PMID   19804475. S2CID   24861855.
  9. Etgen, T.; Sander, D.; Bickel, H.; Sander, K.; Förstl, H. (2012). "Vitamin D Deficiency, Cognitive Impairment and Dementia: A Systematic Review and MetaAnalysis" (PDF). Dementia and Geriatric Cognitive Disorders. 33 (5): 297–305. doi:10.1159/000339702. PMID   22759681. S2CID   5303760.