A Little Known Topic “What is Functional Confusion”: A Systematic Review

Yıl 2024, , 107 - 112, 17.05.2024

Salim Çağatay Kağızman , Cicek Hocaoglu

https://doi.org/10.32708/uutfd.1344784

Öz

The term confusion is defined as disorientation towards time, place or person. There are several identified causes of confusion. The functional etiology of confusion is one of the the least known condition. In the psychiatric examinations situations like that confusing and not defining complaints, not focusing on the story, and not getting purposeful answers can be seen during the session. In such cases, the existence of functional confusion can be suggested. The most important risk factor for functional confusion is tought to be the presence of both current and childhood traumatic life experiences. Functional confusion can be seen in psychiatric disorders. In this article, functional confusion will be defined and its clinical presentation will be examined.

Anahtar Kelimeler

functional confusion, psychiatric disorders, pseudodelirium, dissociation

Az Bilinen Bir Konu “Fonksiyonel Konfüzyon nedir”: Bir Gözden Geçirme

Öz

Zamana, yere ya da kişiye karşı yönelim bozukluğunun görüldüğü bilinç bozukluğu konfüzyon olarak tanımlanır. Konfüzyonun tanımlanmış çeşitli nedenleri vardır. Konfüzyonun fonksiyonel etiyolojisi en az bilinen durumlardan biridir. Psikiyatri muayenelerinde seans esnasında kafa karıştıran ve tanımlayıcı olmayan şikayetler, hikâyeye odaklanamama, anlamlı cevaplar alamama gibi durumlar görülebilir. Bu gibi durumlarda, fonksiyonel konfüzyonun varlığından söz edilebilir. Fonksiyonel konfüzyon için en önemli risk faktörünün hem güncel hem de çocukluk çağındaki travmatik yaşam deneyimlerinin varlığı olduğu düşünülmektedir. Psikiyatrik bozukluklarda fonksiyonel konfüzyon görülebilir. Bu yazıda fonksiyonel konfüzyon tanımlanacak ve klinik sunumu incelenecektir.

Anahtar Kelimeler

fonksiyonel konfüzyon, pskiyatrik bozukluklar, psödodeliryum, disosiyasyon

Kaynakça

• 1. Millan MJ, Agid Y, Brüne M, Bullmore ET, Carter CS, Clayton NS, et al. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov. 2012;11(2):141-68.
• 2. Karamustafalıoğlu O. Temel ve klinik psikiyatri. Güneş Tıp Kitapevleri. 2018.
• 3. Felten DL, O'Banion MK, Maida ME. Netter's atlas of neuroscience: Elsevier Health Sciences; 2015.
• 4. American Psychiatric Association D, Association AP. Diagnostic and statistical manual of mental disorders: DSM-5: American psychiatric association Washington, DC; 2013.
• 5. Akkuş, D Evyapan. Bilinç bozukluğunun nörolojik nedenlerine yaklaşım. 2012.
• 6. Kıyat-Atamer A; Krespi Y. Komanın nedenleri ve nörofizyopatolojisi. 2012.
• 7. Delvecchio G, Rossetti MG, Caletti E, Arighi A, Galimberti D, Basilico P, et al. The neuroanatomy of somatoform disorders: a magnetic resonance imaging study. Psychosomatics. 2019;60(3):278-88.
• 8. Altıparmak T. Fonks􀵴yonel nöroloj􀵴k semptom bozukluğu. Coşar B, ed􀵴tör. Somat􀵴k Bel􀵴rt􀵴 ve İl􀵴şk􀵴l􀵴 Bozukluklar. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. p.25-31
• 9. Öztürk MO, Uluşahin A. Ruh sağlığı ve bozuklukları. 15 ed. Ankara: Nobel Tıp Kitabevleri; 2018.
• 10. Taylor D, Lewis S. Delirium. J Neurol Neurosurg Psychiatry 1993;56(7):742-51.
• 11. Nakatani Y. [Dissociative disorders: from Janet to DSM-IV]. Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica. 2000;102(1):1-12.
• 12. Lebois LAM, Kumar P, Palermo CA, Lambros AM, O'Connor L, Wolff JD, et al. Deconstructing dissociation: a triple network model of trauma-related dissociation and its subtypes. Neuropsychopharmacology. 2022;47(13):2261-70.
• 13. Devillé C, Moeglin C, Sentissi O. Dissociative disorders: between neurosis and psychosis. Case Rep Psychiatry. 2014;2014.
• 14. Ozdemir, O., & Ozdemir, P. G. (2022). Psikiyatride Fonksiyonel Konfüzyon. Psikiyatride Güncel Yaklaşımlar, 14(1), 113-118.
• 15. Staniloiu A, Markowitsch HJ. Dissociative amnesia. The Lancet Psychiatry. 2014;1(3):226-41.
• 16. Katzman W, Papouchis N. Effects of childhood trauma on mentalization capacities and dissociative experiences. J Trauma Dissociation. 2023;24(2):284-95.
• 17. Luminet O, Nielson KA, Ridout N. Cognitive-emotional processing in alexithymia: an integrative review. Cogn Emot. 2021;35(3):449-87.
• 18. Dereboy, İ. F. (1990). Aleksitimi: Bir gözden geçirme. Türk Psikiyatri Dergisi, 1(3), 157-165.
• 19. Sharma A, McClellan J. Emotional and Behavioral Dysregulation in Severe Mental Illness. Child Adolesc Psychiatr Clin N Am. 2021;30(2):415-29.
• 20. Helie S, et al. The roles of valuation and reward processing in cognitive function and psychiatric disorders. Annals of the New York Academy of Sciences, 2017, 1395.1: 33-48.
• 21. Grover S; Kate N. Assessment scales for delirium: A review. World journal of psychiatry, 2012, 2.4: 58.
• 22. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. 1986.
• 23. Esen Danacı A, Böke O, Saka MC, Erol A, Ulusoy Kaymak S. Şizofreni ve diğer psikotik bozukluklar. 3 ed. Ankara: Türkiye Psikiyatri Derneği Yayınları; 2021.
• 24. Cotter J, Drake RJ, Bucci S, Firth J, Edge D, Yung AR. What drives poor functioning in the at-risk mental state? A systematic review. Schizophr Res. 2014;159(2-3):267-77.
• 25. Das S, Malhotra S, Basu D. Family study of acute and transient psychotic disorders: comparison with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1999;34:328-32.
• 26. Wilson JE, Andrews P, Ainsworth A, Roy K, Ely EW, Oldham MA. Pseudodelirium: psychiatric conditions to consider on the differential for delirium. J Neuropsychiatry Clin Neurosci. 2021;33(4):356-64.
• 27. Işık M. Postpartum psychosis. East J Med. 2018;23(1):60.
• 28. Karmacharya R, England ML, Öngür D. Delirious mania: clinical features and treatment response. J Affect Disord. 2008;109(3):312-6.
• 29. Jacobowski NL, Heckers S, Bobo WV. Delirious mania: detection, diagnosis, and clinical management in the acute setting. J Psychiatr Pract. 2013;19(1):15-28.
• 30. Griswold KS, Del Regno PA, Berger RC. Recognition and differential diagnosis of psychosis in primary care. Am Fam Physician. 2015;91(12):856-63.
• 31. Tekin M, Tekin A. Anksiyete bozukluklarında dissosiyatif belirtiler. Psikiyatride Güncel Yaklaşımlar. 2014;6(4):330-9.
• 32. Loewenstein RJ. Psychogenic amnesia and psychogenic fugue: A comprehensive review. 1993.
• 33. Şar V, Akyüz G, Doğan O. Prevalence of dissociative disorders among women in the general population. Psychiatry Res. 2007;149(1-3):169-76.
• 34. Dieguez S. Ganser syndrome. Neurologic-Psychiatric Syndromes in Focus-Part II. 2018;42:1-22.
• 35. Farina B, Liotti M, Imperatori C. The role of attachment trauma and disintegrative pathogenic processes in the traumatic-dissociative dimension. Front Psychol. 2019:933.
• 36. Nijenhuis ER. Somatoform Dissociation, Agency, and Consciousness. Dissociation and the Dissociative Disorders: Routledge; 2022. p. 528-46.
• 37. Krause-Utz A, Frost R, Winter D, Elzinga BM. Dissociation and alterations in brain function and structure: implications for borderline personality disorder. Curr Psychiatry Rep. 2017;19:1-22.
• 38. Brodsky BS, Cloitre M, Dulit RA. Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. Am J Psychiatry. 1995;152(12):1788-92.
• 39. Detweiler MB, Mehra A, Rowell T, Kim KY, Bader G. Delirious mania and malignant catatonia: a report of 3 cases and review. Psychiatr Q. 2009;80:23-40.
• 40. Reinfeld S, Yacoub A. An Examination of Electroconvulsive Therapy and Delivery of Care in Delirious Mania. J ECT. 2022;38(3):200-4.
• 41. Herrera MP, Zimmerman AM. Case of refractory delirious mania responsive to lithium. BJPsych Open. 2021;7(4):e119.