Consciousness, Disorders of

Consciousness, Disorders of


There is no single definition of the concept of the disturbed consciousness in contemporary psychiatry. According to the most widely held point of view, the only abnormal conditions categorized as disorders of consciousness are those in which the perception of external objects and spatial and temporal orientation are disrupted, thinking is disordered, events are not fixed in the memory, and alienation from the real world sets in (K. Jaspers). Each of these symptoms is observed in various psychic disorders, but in combination they are characteristic of clouded consciousness. As a result, disorders of consciousness are characterized by the disruption of abstract logical and visual sensory cognition.

In clinical practice, stupor is the most frequently encountered disorder of consciousness, manifested in retardation, somnolence, impoverished psychic life, and elevated threshold for external irritants. Cases range from mild (clouding of consciousness) to extremely severe, characterized by sopor and coma. Delirious clouding of consciousness, or delirium, is characterized by illusions, hallucinations, affective disorders, acute delirium, and motor excitation, in combination with symptoms common to all forms of disruption of consciousness.

Characteristic of oneiric (dreamlike) clouding of consciousness are fantastic, sensual, daydream-like experiences, acute affective and motor disorders and disruption of self-consciousness. The dominant symptom in amentia is gross disorder of the flow of associative processes (incoherent, fragmentary thinking), accompanied by motor excitation, incoherent talkativeness, and continual changes of mood.

Unlike the above-mentioned syndromes, the twilight state develops suddenly, is generally brief (minutes or hours), and has a distinct onset and termination. The patient’s outward behavior often seems purposeful and logical, but malicious-depressed affect, acute delirium, and vivid hallucinations may bring on outbursts of furious excitation, with senseless aggression.


Megrabian, A. A. O priorode individual’nogo soznaniia (V norme i patologii). Erevan, 1959.
Gertsberg, M. O. Ocherki po probleme soznaniia v psikhopatologii. Moscow, 1961.
Problemy soznaniia: Materialy simpoziuma. Moscow, 1966.
Papadopulos, T. F. “Problema rasstroistv soznaniia v sovremennoi psikhiatrii.” Zhurnal nevropatologii i psikhiatrii im. S. S. Korsakova, 1969, vol. 69, no. 3, pp. 444–56.
Rosenfeld, M. Die Störungen des Bewusstseins. Leipzig, 1929.
Hirsch, W., and K. Rust. Bewusstseinsverlust, 2nd ed. Leipzig, 1958.


References in periodicals archive ?
Eighteen major themes are identified, including, among others, attention, audition, cognition, consciousness, disorders of perception, philosophical approaches, physiologic processes, sense interactions, and visual perception.