Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Confusion”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2005

Inferential confusion in obsessive-compulsive disorder: the inferential confusion questionnaire.

The current article represents the further validation of the construct of inferential confusion amongst clinical samples. Inferential confusion is proposed to be a meta-cognitive confusion particularly relevant to obsessive compulsive disorder (OCD) that leads a person to confuse an imagined possibility with an actual probability. As such, it conceptualizes OCD as a form of belief disorder similar to a delusion or overvalued idea that is a product of distorted reasoning processes. In contrast, other cognitive models of OCD emphasize a phobic model of development in OCD, and thus consider the exaggerated interpretation of intrusions as an essential element in OCD. The present study administered a revised version of the Inferential Confusion Questionnaire, and the Obsessive Belief Questionnaire (OBQ), to a total of 183 participants in three clinical groups and a non-clinical control group. Results suggest that OCD, at least in part, follows a non-phobic model of development with inferential confusion significantly related to obsessive-compulsive symptoms independently of cognitive domains as measured by the OBQ, and mood states. Further, scores on inferential confusion were particularly high in those with OCD and delusional disorder as compared to anxious and non-clinical controls.

Adolescent↗
PubMedDate not supplied

Early detection of postoperative delirium and confusion in a surgical ward using the NEECHAM confusion scale.

The early detection and prevention of postoperative delirium and confusion has become an important issue in surgical ward management. With the aim of determining an objective technique for early detection of delirium, 64 patients admitted to a surgical ward before surgery were examined using the NEECHAM confusion scale. On the 2nd postoperative day they were tested again and divided into 3 groups on the basis of their NEECHAM scores: high risk, low risk, and no risk, for confusion. The trends of the NEECHAM scores in the 3 groups were compared, and the relationship between the NEECHAM scores and suspected clinical risk factors for delirium was investigated. Use of NEECHAM scaling enabled medical staff to identify cases of possible confusion early, indicating that the NEECHAM confusion scale should be useful for the detection of postoperative delirium and confusion in the surgical ward.

Adult↗
PubMed2003

Now you see it, now you don't--the confusing case of confusion as an emotion: commentary on Rozin and Cohen (2003).

P. Rozin and A. B. Cohen (2003) contend that confusion is an emotion because it is valenced, it has a distinct facial expression, and it has a distinct internal state. On the basis of these criteria, they call for further study of this unstudied stateand challenge emotion researchers to consider "confusion" to be an emotion. The author agrees with Rozin and Cohen (2003) that confusion is an affective state, is valenced, has an (internal) object, may be expressed facially, and that laypersons may, under certain circumstances, consider it an emotion. However, its expression is likely to be an expressive component of emotions for which goal obstruction is central. Further, confusion may also not be as commonly considered an emotion by laypersons, as Rozin and Cohen contend. Finally, confusion is not unstudied, only most of the time it is not emotion researchers who do the researching.

Confusion↗
PubMed1989

Problems of basic nursing care in acutely confused and non-confused hip-fracture patients.

Thirty-five patients operated on for femoral neck fracture were studied. Fifteen (42.9%) became acutely confused after surgery. Problems in the 14 components of basic nursing care (Henderson 1964), were identified by means of interviews with the patients and their caregivers. The quantitative analysis of the results showed that significantly more of the acutely confused patients had problems in nine out of 14 components of basic nursing care as compared with the non-confused patients. The qualitative analysis showed that the problems of the non-confused patients were mostly caused by the fracture and by hospitalisation. The same problems were also present among the acutely confused patients who, in addition, had problems which arose from the acute confusional state.

Activities of Daily Living↗
PubMed2000

The bedside confusion scale: development of a portable bedside test for confusion and its application to the palliative medicine population.

BACKGROUND: Clinical tests for confusion in medically ill patients are frequently burdensome and difficult to use. Available tests lack portability and tend to be shunned in clinical practice by physicians. OBJECTIVE: To develop a simple, sensitive bedside test for confusion. DESIGN: Prospective comparison study. SETTING: An in-patient palliative medicine unit in a large urban hospital. PATIENTS: Thirty-one consecutive patients admitted to the unit. INTERVENTION: None. MEASUREMENTS: A 2-minute screening test, the Bedside Confusion Scale (BCS), which utilizes an observation of level of consciousness at the time of clinical interaction, followed by a timed task of attention, was administered to 31 consecutively admitted patients. The results were compared to a previously validated test, the Confusion Assessment Method (CAM). The BCS and the CAM were scored in standardized fashion and results of the two populations compared. Demographic and clinical characteristics of the patient population, along with the Karnofsky performance scores (KPS) and neurological findings were registered. RESULTS: Using the CAM as the reference standard, the sensitivity of the BCS was 100%. Worsening KPS and more abnormalities on neurological examination were seen across normal (BCS = 0), borderline (BCS = 1), and abnormal (BCS >/= 2) groups (p > 0.01, trend test). CONCLUSIONS: In an in-patient palliative medicine population, the BCS correlates with the previously validated CAM and exhibits high sensitivity, an essential quality of a useful screening test.

Journal Article↗
PubMed2003

[Confusing stories, not always confusion! Language disorders and dementia].

Sometimes confusing stories may have unexpected causes. A confused patient is not necessarily delirious or demented. We present three patients in which diagnosis was difficult. Their confusion appeared to be caused only partially by memory impairment. Dementia often presents with memory impairment, but sometimes a language disorder is more prominent. Ten percent of the dementias show language disturbances as the first sign. Language disturbances may exist for a long time, even before the onset of the memory impairment. The language disorder causes difficulty in proper judgment of memory. Logopedic examination is necessary to diagnose the language disorder. Neuropsychological testing should take the language disorder into account. Diagnostic accuracy is important. Distinguishing dementia from a language disorder has implications for the judgment of the patient's (dis)abilities and management.

Aged↗
PubMed1990

[Prolonged confusion syndrome in the course of cyclosporine treatment: a state of confusion?].

Cyclosporine is a potent immunosuppressant that is more and more widely used, particularly after organ transplantations. Many neurological side effects, including convulsions, that could be related to this drug, have been previously observed, most often with high blood concentrations. We report, for the first time, a case of prolonged confusion where a non convulsive status epilepticus may be discussed. It occurred in a 64-year-old woman, 17 days after a liver transplantation. The whole blood cyclosporine value was 230 micrograms/l (normal range: 100-200 micrograms/l) at the beginning of the status epilepticus. The cyclosporine imputability and the part of other factors that could have facilite are discussed.

Chronic Disease↗
PubMed2005

Detection of delirium in the intensive care unit: comparison of confusion assessment method for the intensive care unit with confusion assessment method ratings.

OBJECTIVES: To compare the Confusion Assessment Method (CAM) and CAM for the Intensive Care Unit (CAM-ICU) methods for detecting delirium in alert, nonintubated older ICU patients. DESIGN: Comparison study. SETTING: Fourteen-bed medical ICU of an 800-bed university teaching hospital. PARTICIPANTS: Twenty-two patients aged 65 and older admitted to the ICU. MEASUREMENTS: Two blinded, trained clinician-researchers who had undergone interrater reliability testing interviewed patients separately, usually within 10 minutes of each other (up to 120 minutes). Each researcher examined patients for the four key CAM criteria: acuteness, inattention, disorganized thinking, and altered level of consciousness. One researcher used the CAM method with the Mini-Mental State Examination and Digit Span; the other researcher used the CAM-ICU method with nonverbal cognitive and attention tasks. RESULTS: Rates of delirium were 68% according to CAM and 50% according CAM-ICU. Comparing the two methods, agreement was 82%, with a kappa of 0.64. Using the CAM as the reference standard, the CAM-ICU had a sensitivity of 73% (95% confidence interval (CI)=60-86) and specificity of 100% (95% CI=56-100). There were four false-negative ratings using the CAM-ICU. Reasons for disparate results were that the CAM used more-detailed cognitive testing that detected more deficits (3 patients) and the time elapsed (90 minutes) between ratings in one patient with markedly fluctuating symptoms. CONCLUSION: CAM and CAM-ICU agreement was moderately high. Although the CAM-ICU is recommended for ICU patients because of its brevity and ease of use, the standard CAM method may detect more subtle cases of delirium in nonintubated, verbal ICU patients.

Aged↗
PubMed1990

Clarifying confusion: the confusion assessment method. A new method for detection of delirium.

OBJECTIVE: To develop and validate a new standardized confusion assessment method (CAM) that enables nonpsychiatric clinicians to detect delirium quickly in high-risk settings. DESIGN: Prospective validation study. SETTING: Conducted in general medicine wards and in an outpatient geriatric assessment center at Yale University (site 1) and in general medicine wards at the University of Chicago (site 2). PATIENTS: The study included 56 subjects, ranging in age from 65 to 98 years. At site 1, 10 patients with and 20 without delirium participated; at site 2, 16 patients with and 10 without delirium participated. MEASUREMENTS AND MAIN RESULTS: An expert panel developed the CAM through a consensus building process. The CAM instrument, which can be completed in less than 5 minutes, consists of nine operationalized criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). An a priori hypothesis was established for the diagnostic value of four criteria: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. The CAM algorithm for diagnosis of delirium required the presence of both the first and the second criteria and of either the third or the fourth criterion. At both sites, the diagnoses made by the CAM were concurrently validated against the diagnoses made by psychiatrists. At sites 1 and 2 values for sensitivity were 100% and 94%, respectively; values for specificity were 95% and 90%; values for positive predictive accuracy were 91% and 94%; and values for negative predictive accuracy were 100% and 90%. The CAM algorithm had the highest predictive accuracy for all possible combinations of the nine features of delirium. The CAM was shown to have convergent agreement with four other mental status tests, including the Mini-Mental State Examination. The interobserver reliability of the CAM was high (kappa = 0.81 - 1.0). CONCLUSIONS: The CAM is sensitive, specific, reliable, and easy to use for identification of delirium.

Aged↗