Altered mental status classification: Difference between revisions
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==Overview== | ==Overview== | ||
Altered mental status is a common chief complaint among older emergency department (ED) patients. Despite the frequency of this complaint, the term “altered mental status” is vague and has several synonyms such as confusion, not acting right, altered behavior, generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate behavior, inattention, and hallucination. Such lack of standardized terminology not only hinders the assessment and appropriate management of patients with altered mental status. | [[Altered mental status]] is a common chief complaint among older emergency department (ED) patients. Despite the frequency of this complaint, the term “altered mental status” is vague and has several synonyms such as confusion, not acting right, altered [[behavior]], generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate [[behavior]], [[inattention]], and [[hallucination]]. Such lack of standardized terminology not only hinders the assessment and appropriate management of patients with altered mental status. | ||
==Classification== | ==Classification== | ||
* Altered mental status may be classified according to its origin into 4 major groups: [[dementia]], [[delirium]], [[psychosis]], and [[Neurology|neurologic]] causes.<ref name="urlApproach to Altered Mental Status">{{cite web |url=https://www.saem.org/cdem/education/online-education/m4-curriculum/group-m4-approach-to/approach-to-altered-mental-status |title=Approach to Altered Mental Status |format= |work= |accessdate=}}</ref> | |||
=== Dementia === | |||
* Typically, [[dementia]] is a slow and progressive decline in [[Cognition|cognitive function]] due to damage or [[disease]] in the [[brain]] beyond what might be expected from normal [[Ageing|aging]]. Individuals usually present normal [[vital signs]], normal level of conscioussness. | |||
=== Delirium === | |||
* [[Delirium]] is an acute and relatively sudden (developing over hours to days) decline in attention-focus, perception, and [[cognition]]. It is not synonymous with [[drowsiness]], and may occur without it. It is commonly associated with a disturbance of [[consciousness]] (e.g., reduced clarity of awareness of the environment). The change in [[cognition]] (memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance, must be one that is not better accounted by a preexisting, established, or evolving [[dementia]]. Usually the rapidly fluctuating time course of delirium is used to help in the latter distinction. | |||
=== Psychosis === | |||
* Psychosis is a generic [[Psychiatry|psychiatric]] term for a [[Mental status examination|mental state]] often described as involving a "loss of contact with reality". ''Stedman's Medical Dictionary'' defines psychosis as "a severe mental disorder, with or without organic damage, characterized by derangement of [[personality]] and loss of contact with reality and causing deterioration of normal social functioning."<ref>{{cite web | url = http://www.kmle.com/search.php?Search=psychosis | title = ''KMLE Medical Dictionary Definition of psychosis'' | author = [http://www.kmle.com The American Heritage Stedman's Medical Dictionary]}}</ref> | |||
=== Neurologic causes === | |||
* Some focal neurological deficits can produce changes in [[perception]], psychomotor skills or [[behavior]]. This group's presentation vary widely depending on the localization and cause of impairment. | |||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 06:42, 2 August 2020
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Altered mental status On the Web |
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American Roentgen Ray Society Images of Altered mental status |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]
Overview
Altered mental status is a common chief complaint among older emergency department (ED) patients. Despite the frequency of this complaint, the term “altered mental status” is vague and has several synonyms such as confusion, not acting right, altered behavior, generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate behavior, inattention, and hallucination. Such lack of standardized terminology not only hinders the assessment and appropriate management of patients with altered mental status.
Classification
- Altered mental status may be classified according to its origin into 4 major groups: dementia, delirium, psychosis, and neurologic causes.[1]
Dementia
- Typically, dementia is a slow and progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Individuals usually present normal vital signs, normal level of conscioussness.
Delirium
- Delirium is an acute and relatively sudden (developing over hours to days) decline in attention-focus, perception, and cognition. It is not synonymous with drowsiness, and may occur without it. It is commonly associated with a disturbance of consciousness (e.g., reduced clarity of awareness of the environment). The change in cognition (memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance, must be one that is not better accounted by a preexisting, established, or evolving dementia. Usually the rapidly fluctuating time course of delirium is used to help in the latter distinction.
Psychosis
- Psychosis is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality". Stedman's Medical Dictionary defines psychosis as "a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration of normal social functioning."[2]
Neurologic causes
- Some focal neurological deficits can produce changes in perception, psychomotor skills or behavior. This group's presentation vary widely depending on the localization and cause of impairment.