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Psychosomatic Medicine and Liaison Psychiatry pp 247–279Cite as

Delirium, Clouding of Consciousness, and Confusion

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Abstract

Delirium has been for years the Cinderella of English-language psychiatry: taken for granted, ignored, and not considered worthy of study. Whatever the reasons for this neglect might be, several recent developments in psychiatry and psychology fully justify a reexamination of this syndrome and its conceptual framework. The growth of experimental psychopathology, and particularly the study of drug-induced model psychoses as well as of the psychological effects of variation of sensory input and of sleep deprivation, invite comparison with that “experiment of nature” which is delirium. The concept of consciousness has recovered its respectability in psychology and the class of disorders designated “disturbances of consciousness” has recently attracted the attention of scientists from various disciplines.111 Progress in the understanding of the neural substrate of conscious experience has been spearheaded by neuroanatomists and neurophysiologists.14,36 The rapid development of general hospital psychiatry has given access and opportunity for the study of psychiatric complications of somatic disease to an extent unparalleled in the history of psychiatry. Psychiatrists working on the medical and surgical wards must deal with the diagnostic and therapeutic problems of delirium and related states as part of their liaison work.86 There has been dissatisfaction with the current classification of the so-called organic brain syndromes and salutary recognition that their study “touches on the basic questions of the biological organization of drives, affects, and cognitive processes.”99 Current interest in cognition60 should extend to delirium in which disorganization of cognitive processes is the chief feature.

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Lipowski, Z.J. (1967). Delirium, Clouding of Consciousness, and Confusion. In: Psychosomatic Medicine and Liaison Psychiatry. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2509-3_14

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