Confusional States: A Review
Abstract
Confusional states are a group of multi-faceted disorders that are characterized by an altered state of consciousness, impaired cognitive functioning, and disorientation. This review provides an overview of the current state of knowledge regarding the epidemiology, etiology, clinical manifestations and treatment of confusional states. Relevant studies on the topic are discussed, along with current evidence-based treatment options.
Introduction
Confusional states are a heterogeneous group of disorders characterized by an altered state of consciousness, impaired cognitive functioning, and disorientation (American Psychiatric Association, 2013). These states can be broadly divided into two categories: organic and functional. Organic confusional states are caused by a physiological dysfunction, such as a stroke or a brain tumor, while functional confusional states are caused by psychological or emotional distress. Although confusional states are not a single disorder, they are often associated with a wide range of psychological and physical symptoms.
Epidemiology
The exact prevalence of confusional states is unknown, but it is estimated that up to 10% of patients in general medical settings have a confusional state (Kutner, 2010). The prevalence is higher in the elderly population, with estimates ranging from 10-20% (van der Mast, 2011).
Etiology
Organic confusional states are typically caused by an underlying medical condition, such as a stroke, a head injury, a brain tumor, or an infection. Other potential causes include electrolyte imbalances, drug toxicity, and metabolic disturbances. Functional confusional states are most commonly caused by psychological distress, such as severe anxiety or depression, or by substance use (American Psychiatric Association, 2013).
Clinical Manifestations
The clinical manifestations of confusional states vary depending on the underlying cause. Generally, patients will present with some combination of altered consciousness, disorientation, confusion, impaired memory, disorganized behavior, and impaired judgment (American Psychiatric Association, 2013).
Treatment
The treatment of confusional states depends on the underlying cause. For organic confusional states, the primary goal is to identify and treat the underlying cause. This may include prescribing medications, providing supportive care, or performing surgery. For functional confusional states, the goal is to identify and treat the underlying psychological or emotional distress. This may involve prescribing medications, providing psychotherapy, or recommending lifestyle changes.
Conclusion
Confusional states are a heterogeneous group of disorders characterized by an altered state of consciousness, impaired cognitive functioning, and disorientation. The epidemiology, etiology, clinical manifestations and treatment of confusional states have been reviewed in this article. Further research is needed to better understand the underlying causes of confusional states and to develop effective treatment strategies.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Kutner, J.S. (2010). Confusional states in the medical patient. American Family Physician, 81(10), 1241-1247.
van der Mast, R.C., & Jolles, J. (2011). Delirium in elderly people. Lancet, 378(9807), 2152-2161.