Altered mental status historical perspective
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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
- Altered mental status was poorly understood before 19th century and was merely seen as symptoms of intoxication or demonic possession.[10]
- Many times, individuals with altered mental status due to 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 "Delirium" by Laura Restrepo.
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
- ↑ 1.0 1.1 "Science & Technology: consciousness". Encyclopædia Britannica. Retrieved August 20, 2010.
- ↑ 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.
- ↑ Cruz-Coke R (May 1999). "[Hippocratic philosophy]". Rev Med Chil (in Spanish; Castilian). 127 (5): 611–4. PMID 10451633.
- ↑ {{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}}
- ↑ Berrios, G. E. (1994). "Dementia: Historical Overview": 5–19. doi:10.1007/978-1-4615-6805-6_1.
- ↑ Locke, John. "An Essay Concerning Human Understanding (Chapter XXVII)". Australia: University of Adelaide. Retrieved August 20, 2010.
- ↑ 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.
- ↑ "Evolución histórica de la enciclopedia: Diderot y la enciclopedia francesa. Biblioteca Nacional de España".
- ↑ 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.
- ↑ "ndl.ethernet.edu.et" (PDF).
- ↑ 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.