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[PMID]:26951409
[Au] Autor:Heidbreder A; Frauscher B; Mitterling T; Boentert M; Schirmacher A; Hörtnagl P; Schennach H; Massoth C; Happe S; Mayer G; Young P; Högl B
[Ad] Endereço:Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Muenster, Germany.
[Ti] Título:Not Only Sleepwalking But NREM Parasomnia Irrespective of the Type Is Associated with HLA DQB1*05:01.
[So] Source:J Clin Sleep Med;12(4):565-70, 2016 Apr 15.
[Is] ISSN:1550-9397
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVES: Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only. METHODS: We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia gathered from four neurological sleep centers. Parasomniac events were classified according to ICSD-2 criteria. HLA DQB1 genotyping was compared to regional-matched reference allele-frequencies. RESULTS: Fifty-six patients had more than 2 different parasomnia type: 11 sleepwalking, 4 sleep terrors, 3 confusional arousals only. Parasomniac events were documented during video-polysomnography (V-PSG) in 70% (49/70) of subjects (71.4% confusional arousals, 8.2% sleep terrors, 4.1% sleepwalking, 16.3% ≥ 2 NREM parasomnia types). Violent behavior during V-PSG occurred in 8.5% (6/71). NREM parasomnia onset was reported after the age of 30 years in 6.8% (5/74). The HLA DQB1*05:01 allele was present in 41% (29/71) compared to 24.2% in the regional-matched reference allele group (p < 0.05). This haplotype prevalence did not differ within the NREM parasomnia type. Epworth Sleepiness Score was 10 or higher in 28.6%. CONCLUSIONS: This is a large polysomnography-based case series of patients with NREM parasomnia. In patients with suspected sleepwalking or sleep terrors, polysomnography is highly useful in detecting arousals from NREM sleep as a marker of NREM parasomnia. We confirmed previous findings by demonstrating a high prevalence of the HLA DQB1*05:01 genotype for different types of NREM parasomnias. Our findings therefore support a common genetic background, and corroborate the importance of video-polysomnography in the work-up of parasomnia.
[Mh] Termos MeSH primário: Cadeias beta de HLA-DQ/genética
Parassonias/genética
Fases do Sono
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Predisposição Genética para Doença/genética
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Transtornos do Despertar do Sono/genética
Sonambulismo/genética
Gravação de Videoteipe
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (HLA-DQ beta-Chains); 0 (HLA-DQB1 antigen)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170130
[Lr] Data última revisão:
170130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160309
[St] Status:MEDLINE
[do] DOI:10.5664/jcsm.5692


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[PMID]:26847987
[Au] Autor:Nayak CS; Sinha S; Nagappa M; Kandavel T; Taly AB
[Ad] Endereço:Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; Department of Clinical Neurosciences, NIMHANS, Bangalore, India.
[Ti] Título:Effect of valproate on the sleep microstructure of juvenile myoclonic epilepsy patients - a cross-sectional CAP based study.
[So] Source:Sleep Med;17:129-33, 2016 Jan.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Studies looking at the effect of anti-epileptic medications on sleep microstructure of patients with epilepsy are almost non-existent. The aim of this study was to compare sleep microstructural characteristics of drug-naïve juvenile myoclonic epilepsy (JME) patients with those on valproate (VPA) monotherapy. METHODS: Three age- (p = 0.287) and gender- (p = 0.766) matched groups (N = 20 in each group): (1) drug-naïve JME (mean age: 21.2 ± 4.06 years; M : F = 9:11); (2) JME on VPA (mean age: 21.85 ± 4.28 years; M : F = 11:9); (3) healthy controls (mean age: 23.2 ± 3.82 years; M : F = 9:11) underwent overnight polysomnography. Scoring and analysis of arousals American Sleep Disorders Association (ASDA, 2002), cyclic alternating pattern (CAP) (Terzano et al., 2002) parameters were performed. Comparison of arousal and CAP parameters was performed using one-way ANOVA, followed by pairwise comparisons using Fisher's LSD test (p ≤ 0.05). RESULTS: Rapid eye movement (REM) arousal indices were higher in JME patients (Group 1 [p = 0.002] and Group 2 [p <0.001]), whereas the overall and NREM arousal indices were comparable between the three groups. CAP rate was higher in JME patients as compared to controls (p <0.001). Duration of phase A and its subtypes (p <0.001) was reduced in drug-naïve patients as compared to VPA group and controls. Finally, percentage of phase A1 (p = 0.003) was decreased and A3 (p = 0.045) was increased in drug-naïve patients as compared to VPA group and controls. CONCLUSIONS: We found significant alterations in REM arousal indices and several CAP parameters in JME patients. However, many of these alterations were not seen in the valproate group. This might indicate that anti-epileptic medications such as valproate may beneficially modulate arousal instability in JME patients, and hence promote sleep quality and continuity.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Epilepsia Mioclônica Juvenil/tratamento farmacológico
Transtornos do Despertar do Sono/tratamento farmacológico
Sono/efeitos dos fármacos
Ácido Valproico/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Anticonvulsivantes/farmacologia
Nível de Alerta/fisiologia
Estudos de Casos e Controles
Estudos Transversais
Feminino
Seres Humanos
Masculino
Epilepsia Mioclônica Juvenil/complicações
Polissonografia
Transtornos do Despertar do Sono/etiologia
Sono REM/efeitos dos fármacos
Inquéritos e Questionários
Ácido Valproico/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 614OI1Z5WI (Valproic Acid)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160206
[St] Status:MEDLINE


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[PMID]:26391803
[Au] Autor:Terzaghi M; Manni R
[Ad] Endereço:Unit of Sleep Medicine and Epilepsy, C. Mondino National Neurological Institute, Pavia, Italy. Electronic address: michele.terzaghi@mondino.it.
[Ti] Título:Mapping the features of arousal parasonmnias in adults: on the way to better understand arousal parasomnias and ease differential diagnosis.
[So] Source:Sleep Med;16(11):1439-1440, 2015 Nov.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Parassonias/diagnóstico
Transtornos do Despertar do Sono/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Nível de Alerta
Diagnóstico Diferencial
Seres Humanos
Polissonografia
[Pt] Tipo de publicação:COMMENT; EDITORIAL
[Em] Mês de entrada:1608
[Cu] Atualização por classe:170805
[Lr] Data última revisão:
170805
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150923
[St] Status:MEDLINE


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[PMID]:25934536
[Au] Autor:Neutel D; Tchikviladzé M; Charles P; Leu-Semenescu S; Roze E; Durr A; Arnulf I
[Ad] Endereço:APHP, Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Paris, France.
[Ti] Título:Nocturnal agitation in Huntington disease is caused by arousal-related abnormal movements rather than by rapid eye movement sleep behavior disorder.
[So] Source:Sleep Med;16(6):754-9, 2015 Jun.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with Huntington disease (HD) and their spouses often complain of agitation during sleep, but the causes are mostly unknown. OBJECTIVE: To evaluate sleep and nocturnal movements in patients with various HD stages and CAG repeats length. METHODS: The clinical features and sleep studies of 29 patients with HD were retrospectively collected (11 referred for genotype-phenotype correlations and 18 for agitation during sleep) and compared with those of 29 age- and sex-matched healthy controls. All patients had videopolysomnography, but the movements during arousals were re-analyzed in six patients with HD with stored video. RESULTS: The patients had a longer total sleep period and REM sleep onset latency, but no other differences in sleep than controls. There was no correlation between CAG repeat length and sleep measures, but total sleep time and sleep efficiency were lower in the subgroup with moderate than milder form of HD. Periodic limb movements and REM sleep behavior disorders were excluded, although 2/29 patients had abnormal REM sleep without atonia. In contrast, they had clumsy and opisthotonos-like movements during arousals from non-REM or REM sleep. Some movements were violent and harmful. They might consist of voluntary movements inappropriately involving the proximal part of the limbs on a background of exaggerated hypotonia. Giant (>65 mcV) sleep spindles were observed in seven (24%) patients with HD and one control. CONCLUSION: The nocturnal agitation in patients with HD seems related to anosognostic voluntary movements on arousals, rather than to REM sleep behavior disorder and other sleep problems.
[Mh] Termos MeSH primário: Doença de Huntington/diagnóstico
Síndrome da Mioclonia Noturna/diagnóstico
Agitação Psicomotora
Transtorno do Comportamento do Sono REM/diagnóstico
Transtornos do Despertar do Sono/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Diagnóstico Diferencial
Feminino
Seres Humanos
Proteína Huntingtina
Doença de Huntington/genética
Masculino
Meia-Idade
Proteínas do Tecido Nervoso/genética
Polissonografia
Estudos Retrospectivos
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (HTT protein, human); 0 (Huntingtin Protein); 0 (Nerve Tissue Proteins)
[Em] Mês de entrada:1602
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150503
[St] Status:MEDLINE


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[PMID]:25795266
[Au] Autor:Organ A; Fedoroff JP
[Ad] Endereço:Algonquin College, Ottawa, Canada.
[Ti] Título:Sexsomnia: sleep sex research and its legal implications.
[So] Source:Curr Psychiatry Rep;17(5):34, 2015 May.
[Is] ISSN:1535-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:"Sleep sex," also known as sexsomnia, is a sleep disorder characterized by sexual behaviors committed while asleep. There has recently been increased interest in sexsomnia due to controversies arising in legal trials that have been widely publicized in the social and public media. This article attempts to marshal the current information about sexsomnia from the forensic literature and provides an overview of sexsomnia including common features, precipitating factors, prevalence rates, diagnostic procedures, and treatment. As sexsomnia represents a condition in which sexual acts are committed without awareness or intention, this paper also reviews the development of sexsomnia as a legal defense and summarizes Canadian case law on the topic. It provides an overview of the hurdles presented to defense attorneys attempting to utilize the defense and examines popular public notions surrounding the legitimacy of sexsomnia and the possibility of malingering. We conclude that sexsomnia is a legitimate sleep disorder for which case law now exists to support its use in legal defenses based on automatism. The question of whether it is an example of "sane" or "insane" automatism remains to be determined by the courts. Regardless of whether or not sexsomnia is determined to be a mental disorder by the courts, it is now a recognized and well-described sleep disorder that can be safely treated and managed by knowledgeable clinicians.
[Mh] Termos MeSH primário: Intoxicação Alcoólica
Automatismo
Psiquiatria Legal
Legislação Médica
Simulação de Doença
Parassonias do Sono REM
Delitos Sexuais/legislação & jurisprudência
Transtornos do Despertar do Sono
Transtornos da Transição Sono-Vigília
[Mh] Termos MeSH secundário: Consumo de Bebidas Alcoólicas
Automatismo/diagnóstico
Automatismo/terapia
Canadá
Diagnóstico Diferencial
Feminino
Psiquiatria Legal/métodos
Psiquiatria Legal/tendências
Seres Humanos
Jurisprudência
Masculino
Simulação de Doença/diagnóstico
Simulação de Doença/terapia
Ontário
Ereção Peniana
Fatores Desencadeantes
Prevalência
Parassonias do Sono REM/diagnóstico
Parassonias do Sono REM/epidemiologia
Parassonias do Sono REM/etiologia
Autorrelato
Delitos Sexuais/psicologia
Comportamento Sexual
Transtornos do Despertar do Sono/diagnóstico
Transtornos do Despertar do Sono/epidemiologia
Transtornos do Despertar do Sono/etiologia
Transtornos da Transição Sono-Vigília/diagnóstico
Transtornos da Transição Sono-Vigília/epidemiologia
Transtornos da Transição Sono-Vigília/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1603
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150322
[St] Status:MEDLINE
[do] DOI:10.1007/s11920-015-0568-y


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[PMID]:25635660
[Au] Autor:Bansal R; Kodali L; Weingarten JA
[Ad] Endereço:New York Methodist Hospital, Brooklyn, New York.
[Ti] Título:Nocturnal groaning: strange sounds in the night.
[So] Source:Ann Am Thorac Soc;12(1):128-30, 2015 Jan.
[Is] ISSN:2325-6621
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Fonação/fisiologia
Síndromes da Apneia do Sono/complicações
Transtornos do Despertar do Sono/etiologia
Voz/fisiologia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Polissonografia
Síndromes da Apneia do Sono/diagnóstico
Síndromes da Apneia do Sono/fisiopatologia
Transtornos do Despertar do Sono/fisiopatologia
Fases do Sono/fisiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1511
[Cu] Atualização por classe:150131
[Lr] Data última revisão:
150131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150131
[St] Status:MEDLINE
[do] DOI:10.1513/AnnalsATS.201407-316CC


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[PMID]:25624338
[Au] Autor:Li Y; Vgontzas AN; Fernandez-Mendoza J; Bixler EO; Sun Y; Zhou J; Ren R; Li T; Tang X
[Ad] Endereço:From the Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China (Y.L., Y.S., J.Z., R.R., T.L., X.T.) and Department of Psychiatry, Sleep Research and Treatment Center, Pe
[Ti] Título:Insomnia with physiological hyperarousal is associated with hypertension.
[So] Source:Hypertension;65(3):644-50, 2015 Mar.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Previous studies have suggested that insomnia with objective short sleep duration is associated with a higher risk of hypertension, and it has been speculated that the underlying mechanism is physiological hyperarousal. In this study, we tested whether insomnia with physiological hyperarousal measured by Multiple Sleep Latency Test (MSLT), a standard test of sleepiness/alertness, is associated with increased risk of hypertension. Two hundred nineteen chronic insomniacs and 96 normal sleepers were included in this study. Chronic insomnia was defined based on standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent 1 night in laboratory polysomnography followed by a standard MSLT. We used the median mean MSLT value (ie, >14 minutes) and the 75th percentile of mean MSLT value (ie, >17 minutes) to define hyperarousal. Hypertension was defined based either on blood pressure measures or on diagnosis treatment by a physician. After controlling for age, sex, body mass index, apnea-hypopnea index, diabetes mellitus, smoking, alcohol, and caffeine use, insomnia combined with MSLT >14 minutes increased the odds of hypertension by 300% (odds ratio=3.27; 95% confidence interval=1.20-8.96), whereas insomnia combined with MSLT >17 minutes increased even further the odds of hypertension by 400% (odds ratio=4.33; 95% confidence interval=1.48-12.68) compared with normal sleepers with MSLT ≤14 minutes. Insomnia associated with physiological hyperarousal is associated with a significant risk of hypertension. Long MSLT values may be a reliable index of the physiological hyperarousal and biological severity of chronic insomnia.
[Mh] Termos MeSH primário: Hipertensão/epidemiologia
Transtornos do Despertar do Sono/complicações
Distúrbios do Início e da Manutenção do Sono/complicações
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Comorbidade
Estudos Transversais
Feminino
Seres Humanos
Hipertensão/fisiopatologia
Masculino
Meia-Idade
Polissonografia
Fatores de Risco
Índice de Gravidade de Doença
Transtornos do Despertar do Sono/epidemiologia
Transtornos do Despertar do Sono/fisiopatologia
Distúrbios do Início e da Manutenção do Sono/epidemiologia
Distúrbios do Início e da Manutenção do Sono/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1504
[Cu] Atualização por classe:160726
[Lr] Data última revisão:
160726
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150128
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.114.04604


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[PMID]:25471634
[Au] Autor:Jaimchariyatam N; Rodriguez CL; Budur K
[Ad] Endereço:Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, drboy48@yahoo.com.
[Ti] Título:Sleep-related cortical arousals in adult subjects with negative polysomnography.
[So] Source:Sleep Breath;19(3):989-96, 2015 Sep.
[Is] ISSN:1522-1709
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The arousal index (AI) quantifies cortical arousal relative to total sleep time and is widely used to determine the severity of sleep fragmentation. It usually includes arousals secondary to respiratory events, limb movements, and spontaneous arousals. No systematic studies have been undertaken to determine AI cutoff in subjects with negative polysomnography. METHODS: Three hundred fifty polysomnograms of subjects ≥18 years of age with no sleep disorders (apnea-hypopnea index (AHI) <5, periodic limb movement index (PLMI) <10, no upper airway resistance syndrome) or minimum oxygen saturation > 90 % and no comorbid health problems were reviewed. RESULTS: Basic sleep architecture appears within normal range, except for increased stage N2 and decreased stage N3. AI significantly correlated with age (r = 0.7), sleep efficiency (r =-0.16), sleep latency (r = 0.14), rapid eye movement (REM) latency (r = 0.12), stage N1 (r = 0.15), stage N2 (r = 0.12), stage N3 (r = -0.27), AHI (r = 0.24), PLMI (r = 0.18), and nadir oxygen saturation (r = -0.17) [p < 0.05 for all]. A significant correlation was noted between age and sleep efficiency (r = -0.19), REM latency (r = 0.13), stage N1 (r = 0.16), stage N2 (r = 0.21), stage N3 (r = -0.39), and nadir oxygen saturation (r = -0.16) [p < 0.05 for all]. Multiple linear regression analysis showed that age is only the independent predictor of AI (R (2) = 0.70, p < 0.01). The prediction equation for the arousal index in subject with negative polysomnography is AI = 0.276 × age (year) + 8.018. CONCLUSIONS: Age is the most important independent factor in predicting increasing AI in subjects with negative polysomnography.
[Mh] Termos MeSH primário: Córtex Cerebral/fisiopatologia
Polissonografia
Transtornos do Despertar do Sono/diagnóstico
Transtornos do Despertar do Sono/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Oxigênio/sangue
Valores de Referência
Privação do Sono/diagnóstico
Privação do Sono/fisiopatologia
Fases do Sono/fisiologia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141205
[St] Status:MEDLINE
[do] DOI:10.1007/s11325-014-1090-x


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[PMID]:25381691
[Au] Autor:Morotti A; Gamba M; De Maria G; Costa P; Poli L; De Giuli V; Gilberti N; Lodoli G; Gasparotti R; Padovani A; Pezzini A
[Ad] Endereço:Dipartimento di Scienze Neurologiche e Della Visione, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.
[Ti] Título:Percheron artery occlusion: an uncommon cause of decreased arousal.
[So] Source:Int J Stroke;9(8):E42-3, 2014 Dec.
[Is] ISSN:1747-4949
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Arteriopatias Oclusivas/complicações
Transtornos do Despertar do Sono/etiologia
[Mh] Termos MeSH secundário: Adulto
Imagem de Difusão por Ressonância Magnética
Eletroencefalografia
Feminino
Seres Humanos
Transtornos do Despertar do Sono/diagnóstico
Tálamo/patologia
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1506
[Cu] Atualização por classe:141110
[Lr] Data última revisão:
141110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141111
[St] Status:MEDLINE
[do] DOI:10.1111/ijs.12395


  10 / 137 MEDLINE  
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[PMID]:25300023
[Au] Autor:European Delirium Association; American Delirium Society
[Ti] Título:The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer.
[So] Source:BMC Med;12:141, 2014 Oct 08.
[Is] ISSN:1741-7015
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delirium is a common and serious problem among acutely unwell persons. Although linked to higher rates of mortality, institutionalisation and dementia, it remains underdiagnosed. Careful consideration of its phenomenology is warranted to improve detection and therefore mitigate some of its clinical impact. The publication of the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5) provides an opportunity to examine the constructs underlying delirium as a clinical entity. DISCUSSION: Altered consciousness has been regarded as a core feature of delirium; the fact that consciousness itself should be physiologically disrupted due to acute illness attests to its clinical urgency. DSM-5 now operationalises 'consciousness' as 'changes in attention'. It should be recognised that attention relates to content of consciousness, but arousal corresponds to level of consciousness. Reduced arousal is also associated with adverse outcomes. Attention and arousal are hierarchically related; level of arousal must be sufficient before attention can be reasonably tested. SUMMARY: Our conceptualisation of delirium must extend beyond what can be assessed through cognitive testing (attention) and accept that altered arousal is fundamental. Understanding the DSM-5 criteria explicitly in this way offers the most inclusive and clinically safe interpretation.
[Mh] Termos MeSH primário: Delírio/diagnóstico
Transtornos do Despertar do Sono/diagnóstico
[Mh] Termos MeSH secundário: Manual Diagnóstico e Estatístico de Transtornos Mentais
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1505
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141010
[St] Status:MEDLINE
[do] DOI:10.1186/s12916-014-0141-2



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