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{{Altered mental status}}
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{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo, M.D.,]] {{PB}}
==Overview==
==Overview==
The description of [[altered mental status]] might have been employed as early as 30,000 years ago. Celsus was the first person to use the word [[delirium]], adapted from phrenitis, the description of alteration in [[consciousness]] by Hippocrates. Procopius gave a detailed description of what now is known as hypoactive and hyperactive [[delirium]]. [[Altered mental status]] was poorly understood before 19th century and was merely seen as [[symptoms]] of [[intoxication]] or demonic possession. A chronic global ischaemia hypothesis due to [[atherosclerosis]] was suggested to be the causant all [[cognitive]] alterations, including [[psychiatric disorders]], such as [[schizophrenia]]. New investigations are being developed to understand the neural and [[psychological]] mechanisms of [[consciousness]], such as priming effects using subliminal stimuli, alterations in consciousness produced by [[trauma]], [[Illnesses|illness]], or [[drugs]].
==Discovery==
==Discovery==


*Acoording to data, "[[Conscious]]" and "[[consciousness]]" was first mentioned in English language back in 16th century; it is derived from the Latin (''con-'' "together" +''scio'' "to know").<ref name=":3" />
*The description of [[altered mental status]] might have been employed as early as 30,000 years ago, many times called "''mystic state''".<ref name=":1">{{cite web|url=http://www.britannica.com/EBchecked/topic/133274/consciousness|title=Science & Technology: consciousness|publisher=Encyclopædia Britannica|accessdate=August 20, 2010}}</ref>
*The modern concept of [[consciousness]] is attributed to the English [[physician]] and phylosopher John Locke,  who published in 1690 his essay "''Concerning Human Understanding"''.<ref name=":0" /> Locke defined [[consciousness]] as "''the perception of what passes in a man's own mind''".<ref name=":1" />.
*Celsus was the first person to use the word [[delirium]] (second century AD) to refer to a mental disorder that appeared after a [[head trauma]] or during [[fever]];<ref name="AdamisTreloar2016">{{cite journal|last1=Adamis|first1=Dimitrios|last2=Treloar|first2=Adrian|last3=Martin|first3=Finbarr C.|last4=Macdonald|first4=Alastair J.D.|title=A brief review of the history of delirium as a mental disorder|journal=History of Psychiatry|volume=18|issue=4|year=2016|pages=459–469|issn=0957-154X|doi=10.1177/0957154X07076467}}</ref> he then equally used the term phrenitis introduced by Hippocrates (500 BC) as a synonym of delirium.<ref name="pmid10451633">{{cite journal |vauthors=Cruz-Coke R |title=[Hippocratic philosophy] |language=Spanish; Castilian |journal=Rev Med Chil |volume=127 |issue=5 |pages=611–4 |date=May 1999 |pmid=10451633 |doi= |url=}}</ref>
*The description of [[altered mental status]] might have been employed as early as 30,000 years ago, many times called "''mystic state''".<ref name=":1" />
*In year 542 AD, Procopius gave a detailed description of [[delirium]] either as violent with [[insomnia]], excitement, shouting, and rushing off in flight (now hyperactive [[delirium]]) or drifted into [[coma]], forgetting all those familiar to them (now hypoactive [[delirium]]).<ref name="AdamisTreloar2016" />
*Acoording to data, "[[Conscious]]" and "[[consciousness]]" was first mentioned in English language back in 16th century; it is derived from the Latin (''con-'' "together" +''scio'' "to know").<ref name=":3"><nowiki>{{cite book |title=Studies in words |author =[[C. S. Lewis|year=1990 |publisher=Cambridge University Press |chapter=Ch. 8: Conscience and conscious |isbn=978-0-521-39831-2}}</nowiki></ref>
*Before the 18th century, [[dementia]] was called imbecility, morosis, fatuitas, anoea, foolishness, stupidity, simplicity, carus, idiocy, dotage, or senility, which was used to refer to the varying degree of [[behavioural]] deterioration.<ref name="Berrios1994">{{cite journal|last1=Berrios|first1=G. E.|title=Dementia: Historical Overview|year=1994|pages=5–19|doi=10.1007/978-1-4615-6805-6_1}}</ref>
*The modern concept of [[consciousness]] is attributed to the English [[physician]] and phylosopher John Locke,  who published in 1690 his essay "''Concerning Human Understanding"''.<ref name=":0">{{cite web|title=An Essay Concerning Human Understanding (Chapter XXVII)|last=Locke|first=John|publisher=University of Adelaide|location=Australia|url=http://ebooks.adelaide.edu.au/l/locke/john/l81u/B2.27.html|accessdate=August 20, 2010}}</ref> Locke defined [[consciousness]] as "''the perception of what passes in a man's own mind''".<ref name=":1" />
*The word [[dementia]] was introduced by Blancard in 1726 to refer to the extinction of the imagination and judgment;<ref name="NäggaMarcusson20142">{{cite journal|last1=Nägga|first1=A. K.|last2=Marcusson|first2=J.|title=Associated physical disease in a demented population|journal=Aging Clinical and Experimental Research|volume=10|issue=6|year=2014|pages=440–444|issn=1594-0667|doi=10.1007/BF03340156}}</ref> in 1765, the word was updated by Diderot as the  abolition of the [[reasoning]] faculty.<ref name="urlEvolución histórica de la enciclopedia: Diderot y la enciclopedia francesa. Biblioteca Nacional de España">{{cite web |url=http://www.bne.es/es/Micrositios/Guias/ObrasReferencia/Enciclopedias/EvolHistorica/EncicloFrancesa/ |title=Evolución histórica de la enciclopedia: Diderot y la enciclopedia francesa. Biblioteca Nacional de España |format= |work= |accessdate=}}</ref>


==Landmark Events in the Development of Treatment Strategies==
==Landmark Events in the Development of Treatment Strategies==
*At the begining of the nineteenth century, studies like those from Rostan in 1823 atributed [[Cognitive disorder|cognitive failure]] to softening of the [[brain]], which was observed by [[post-mortem]] findings in old people who presented [[dementia]] features in life.<ref name="NäggaMarcusson20142" />
*In the 20th century, studies like those from North and Bostock in1925, found atherosclerotic changes in autopsies of many of the patients with dementia, which suggested for many years a 'chronic global ischaemia' hypothesis where all [[Cognitive disorder|cognitive alterations]] were due to [[atherosclerosis]], including disorders such as [[schizophrenia]].<ref name="Berrios1990">{{cite journal|last1=Berrios|first1=G. E.|title=Alzheimer's disease: A conceptual history|journal=International Journal of Geriatric Psychiatry|volume=5|issue=6|year=1990|pages=355–365|issn=0885-6230|doi=10.1002/gps.930050603}}</ref>
*New investigations are being developed to understand the neural and [[psychological]] mechanisms of consciousness, such as priming effects using subliminal stimuli, alterations in [[consciousness]] produced by [[trauma]], [[illness]], or [[drugs]].


==Impact on Cultural History==
==Impact on Cultural History==


* [[Altered mental status]] was poorly understood before 19th century and was merely seen as [[symptoms]] of [[intoxication]] or demonic possession.<ref name="urlndl.ethernet.edu.et">{{cite web |url=http://ndl.ethernet.edu.et/bitstream/123456789/15088/1/Harris%20L.%20Friedman.pdf |title=ndl.ethernet.edu.et |format= |work= |accessdate=}}</ref>
*[[Altered mental status]] was poorly understood before 19th century and was merely seen as [[symptoms]] of [[intoxication]] or demonic possession.<ref name="urlndl.ethernet.edu.et">{{cite web |url=http://ndl.ethernet.edu.et/bitstream/123456789/15088/1/Harris%20L.%20Friedman.pdf |title=ndl.ethernet.edu.et |format= |work= |accessdate=}}</ref>
* Many times, individuals with [[altered mental status]] due to [[Medicine|medical]] or [[psychiatric]] conditions were sentenced to torture, convictions, and death by courts such as the Holy Inquisition.
*Many times, individuals with [[altered mental status]] due to [[Medicine|medical]] or [[psychiatric]] conditions were sentenced to torture, convictions, and death by courts such as the Holy Inquisition.
*[[Altered mental status]] has been described and mentioned in several books over time according to the understanding of the moment, such as the award winning "D''elirium''" by Laura Restrepo.


==Famous Cases==
==Famous Cases==
The origin of the modern concept of consciousness is often attributed to John Locke's ''Essay Concerning Human Understanding'', published in 1690.<ref name=":0">{{cite web|title=An Essay Concerning Human Understanding (Chapter XXVII)|last=Locke|first=John|publisher=University of Adelaide|location=Australia|url=http://ebooks.adelaide.edu.au/l/locke/john/l81u/B2.27.html|accessdate=August 20, 2010}}</ref>  Locke defined consciousness as "the perception of what passes in a man's own mind".<ref name=":1">{{cite web|url=http://www.britannica.com/EBchecked/topic/133274/consciousness|title=Science & Technology: consciousness|publisher=Encyclopædia Britannica|accessdate=August 20, 2010}}</ref> His essay influenced the 18th-century view of consciousness, and his definition appeared in Samuel Johnson's celebrated 'A Dictionary of the English Language|Dictionary (1755).<ref name=":2"><nowiki>{{cite book|title=A Dictionary of the English Language |authors=[[Samuel Johnson |publisher=Knapton |year=1756 |url=</nowiki>http://books.google.com/books?id=fcVEAAAAcAAJ}}</ref>
The earliest English language uses of "conscious" and "consciousness" date back, however, to the 1500s.  The English word "conscious" originally derived from the Latin ''conscius'' (''con-'' "together" +''scio'' "to know"), but the Latin word did not have the same meaning as our word—it meant ''knowing with'', in other words ''having joint or common knowledge with another''.<ref name=":3"><nowiki>{{cite book |title=Studies in words |author =[[C. S. Lewis|year=1990 |publisher=Cambridge University Press |chapter=Ch. 8: Conscience and conscious |isbn=978-0-521-39831-2}}</nowiki></ref>  There were, however, many occurrences in Latin writings of the phrase ''conscius sibi'', which translates literally as "knowing with oneself", or in other words ''sharing knowledge with oneself about something''.  This phrase had the figurative meaning of ''knowing that one knows'', as the modern English word "conscious" does.  In its earliest uses in the 1500s, the English word "conscious" retained the meaning of the Latin ''conscius''.  For example, Thomas Hobbes in ''Leviathan (book)|Leviathan'' wrote: "Where two, or more men, know of one and the same fact, they are said to be Conscious of it one to another."<ref>{{cite book|title=Leviathan: or, The Matter, Forme & Power of a Commonwealth, Ecclesiasticall and Civill |author=Thomas Hobbes |publisher=University Press |year=1904 |url=http://books.google.com/books?id=2oc6AAAAMAAJ |page=39}}</ref>  The Latin phrase ''conscius sibi'', whose meaning was more closely related to the current concept of consciousness, was rendered in English as "conscious to oneself" or "conscious unto oneself".  For example, Archbishop Ussher wrote in 1613 of "being so conscious unto myself of my great weakness".<ref>{{cite book |title=The whole works, Volume 2 |author=[[James Ussher]], [[Charles Richard Elrington]] |page=417 |year=1613 |publisher=Hodges and Smith}}</ref>  Locke's definition from 1690 illustrates that a gradual shift in meaning had taken place.
A related word was '':la:conscientia|conscientia'', which primarily means morality|moral conscience. In the literal sense, "conscientia" means knowledge-with, that is, shared knowledge. The word first appears in Latin juridical texts by writers such as Cicero.<ref>{{cite book|title=Encyclopedia of Religion and Ethics Part 7| authors= James Hastings and John A. Selbie |publisher=Kessinger Publishing| isbn=0-7661-3677-9| year=2003|page=41}}</ref> Here, ''conscientia'' is the knowledge that a witness has of the deed of someone else.<ref>{{cite book |author=G. Melenaar |title=Mnemosyne, Fourth Series |volume=22 |pages=170–180 |publisher=Brill}}</ref> René Descartes (1596–1650) is generally taken to be the first philosopher to use "conscientia" in a way that does not fit this traditional meaning.<ref>{{cite journal| author=Boris Hennig |title=Cartesian Conscientia|journal=British Journal for the History of Philosophy |year=2007 |volume=15 |pages=455–484}}</ref>  Descartes used "conscientia" the way modern speakers would use "conscience".  In ''Search after Truth'' he says "conscience or internal testimony" (''conscientia vel interno testimonio'').<ref>{{cite book |pages=205–206 |title=Consciousness: from perception to reflection in the history of philosophy |isbn=978-1-4020-6081-6 |publisher=Springer |author=Sara Heinämaa, Vili Lähteenmäki, Pauliina Remes (eds.) |year=2007}}</ref>


For many decades, consciousness as a research topic was avoided by the majority of mainstream scientists, because of a general feeling that a phenomenon defined in subjective terms could not properly be studied using objective experimental methods.<ref>{{cite book|authors=Horst Hendriks-Jansen |title=Catching ourselves in the act: situated activity, interactive emergence, evolution, and human thought |year=1996 |publisher=Massachusetts Institute of Technology |page=114 |isbn=0-262-08246-2}}</ref>  In 1975 George Mandler published an influential psychological study which distinguished between slow, serial, and limited conscious processes and fast, parallel and extensive unconscious ones.<ref>Mandler, G. Consciousness: Respectable, useful, and probably necessary. In R.Solso (Ed.)Information processing and cognition: NJ: LEA.</ref> Starting in the 1980s, an expanding community of neuroscientists and psychologists have associated themselves with a field called ''Consciousness Studies'', giving rise to a stream of experimental work published in books,<ref>Mandler, G.  Consciousness recovered: Psychological functions and origins of thought. Philadelphia: John Benjamins. 2002</ref> journals such as Consciousness and Cognition, and methodological work published in journals such as the Journal of Consciousness Studies, along with regular conferences organized by groups such as the Association for the Scientific Study of Consciousness.<ref>{{cite book |title=Toward a Science of Consciousness III: The Third Tucson Discussions and Debates |authors=[[Stuart Hameroff]], Alfred Kaszniak, [[David Chalmers]] |chapter=Preface |isbn=978-0-262-58181-3 |publisher=MIT Press |year=1999 |pages=xix–xx}}</ref>
*The creativity and the work of famous paintings such as “''The Starry Night''” from Vincent van Gogh is well known to be influenced in someway by alterations in [[mental status]]; it is still not completly known if it may be due to the effects of absinthe, overmedication with [[digitalis]], [[epilepsy]] or a [[manic depression]].<ref name="pmid11694494">{{cite journal |vauthors=Wolf P |title=Creativity and chronic disease. Vincent van Gogh (1853-1890) |journal=West J Med |volume=175 |issue=5 |pages=348 |date=November 2001 |pmid=11694494 |pmc=1071623 |doi=10.1136/ewjm.175.5.348 |url=}}</ref>


Modern scientific investigations into consciousness are based on psychological experiments (including, for example, the investigation of priming effects using subliminal stimuli), and on case studies of alterations in consciousness produced by trauma, illness, or drugs.  Broadly viewed, scientific approaches are based on two core concepts.  The first identifies the content of consciousness with the experiences that are reported by human subjects; the second makes use of the concept of consciousness that has been developed by neurologists and other medical professionals who deal with patients whose behavior is impaired.  In either case, the ultimate goals are to develop techniques for assessing consciousness objectively in humans as well as other animals, and to understand the neural and psychological mechanisms that underlie it.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D., Pratik Bahekar, MBBS [2]

Overview

The description of altered mental status might have been employed as early as 30,000 years ago. Celsus was the first person to use the word delirium, adapted from phrenitis, the description of alteration in consciousness by Hippocrates. Procopius gave a detailed description of what now is known as hypoactive and hyperactive delirium. Altered mental status was poorly understood before 19th century and was merely seen as symptoms of intoxication or demonic possession. A chronic global ischaemia hypothesis due to atherosclerosis was suggested to be the causant all cognitive alterations, including psychiatric disorders, such as schizophrenia. New investigations are being developed to understand the neural and psychological mechanisms of consciousness, such as priming effects using subliminal stimuli, alterations in consciousness produced by trauma, illness, or drugs.

Discovery

  • The description of altered mental status might have been employed as early as 30,000 years ago, many times called "mystic state".[1]
  • Celsus was the first person to use the word delirium (second century AD) to refer to a mental disorder that appeared after a head trauma or during fever;[2] he then equally used the term phrenitis introduced by Hippocrates (500 BC) as a synonym of delirium.[3]
  • In year 542 AD, Procopius gave a detailed description of delirium either as violent with insomnia, excitement, shouting, and rushing off in flight (now hyperactive delirium) or drifted into coma, forgetting all those familiar to them (now hypoactive delirium).[2]
  • Acoording to data, "Conscious" and "consciousness" was first mentioned in English language back in 16th century; it is derived from the Latin (con- "together" +scio "to know").[4]
  • Before the 18th century, dementia was called imbecility, morosis, fatuitas, anoea, foolishness, stupidity, simplicity, carus, idiocy, dotage, or senility, which was used to refer to the varying degree of behavioural deterioration.[5]
  • The modern concept of consciousness is attributed to the English physician and phylosopher John Locke, who published in 1690 his essay "Concerning Human Understanding".[6] Locke defined consciousness as "the perception of what passes in a man's own mind".[1]
  • The word dementia was introduced by Blancard in 1726 to refer to the extinction of the imagination and judgment;[7] in 1765, the word was updated by Diderot as the abolition of the reasoning faculty.[8]

Landmark Events in the Development of Treatment Strategies

  • At the begining of the nineteenth century, studies like those from Rostan in 1823 atributed cognitive failure to softening of the brain, which was observed by post-mortem findings in old people who presented dementia features in life.[7]
  • In the 20th century, studies like those from North and Bostock in1925, found atherosclerotic changes in autopsies of many of the patients with dementia, which suggested for many years a 'chronic global ischaemia' hypothesis where all cognitive alterations were due to atherosclerosis, including disorders such as schizophrenia.[9]
  • New investigations are being developed to understand the neural and psychological mechanisms of consciousness, such as priming effects using subliminal stimuli, alterations in consciousness produced by trauma, illness, or drugs.

Impact on Cultural History

Famous Cases

  • The creativity and the work of famous paintings such as “The Starry Night” from Vincent van Gogh is well known to be influenced in someway by alterations in mental status; it is still not completly known if it may be due to the effects of absinthe, overmedication with digitalis, epilepsy or a manic depression.[11]

References

  1. ↑ 1.0 1.1 "Science & Technology: consciousness". Encyclopædia Britannica. Retrieved August 20, 2010.
  2. ↑ 2.0 2.1 Adamis, Dimitrios; Treloar, Adrian; Martin, Finbarr C.; Macdonald, Alastair J.D. (2016). "A brief review of the history of delirium as a mental disorder". History of Psychiatry. 18 (4): 459–469. doi:10.1177/0957154X07076467. ISSN 0957-154X.
  3. ↑ Cruz-Coke R (May 1999). "[Hippocratic philosophy]". Rev Med Chil (in Spanish; Castilian). 127 (5): 611–4. PMID 10451633.
  4. ↑ {{cite book |title=Studies in words |author =[[C. S. Lewis|year=1990 |publisher=Cambridge University Press |chapter=Ch. 8: Conscience and conscious |isbn=978-0-521-39831-2}}
  5. ↑ Berrios, G. E. (1994). "Dementia: Historical Overview": 5–19. doi:10.1007/978-1-4615-6805-6_1.
  6. ↑ Locke, John. "An Essay Concerning Human Understanding (Chapter XXVII)". Australia: University of Adelaide. Retrieved August 20, 2010.
  7. ↑ 7.0 7.1 Nägga, A. K.; Marcusson, J. (2014). "Associated physical disease in a demented population". Aging Clinical and Experimental Research. 10 (6): 440–444. doi:10.1007/BF03340156. ISSN 1594-0667.
  8. ↑ "Evolución histórica de la enciclopedia: Diderot y la enciclopedia francesa. Biblioteca Nacional de España".
  9. ↑ Berrios, G. E. (1990). "Alzheimer's disease: A conceptual history". International Journal of Geriatric Psychiatry. 5 (6): 355–365. doi:10.1002/gps.930050603. ISSN 0885-6230.
  10. ↑ "ndl.ethernet.edu.et" (PDF).
  11. ↑ Wolf P (November 2001). "Creativity and chronic disease. Vincent van Gogh (1853-1890)". West J Med. 175 (5): 348. doi:10.1136/ewjm.175.5.348. PMC 1071623. PMID 11694494.

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