I) Quantitative disorders
The study of altered states of consciousness has undergone significant changes over time, resulting in various classifications.
The one I present below is yet another. I believe the most important thing is that we understand the clinical implications of each of the concepts included in it.
Classically, disorders of consciousness, depending on the clinical presentation, could be subdivided into:
- Quantitative disorders of consciousness.
- Clouding of consciousness.
- Dullness.
- drowsiness.
- Drowsiness/stupor.
- Coma.
- Hypervigilance or hyperphrenia and mystical states.
- Qualitative disorders of consciousness.
- delusional states.
- twilight states.
- Pathological intoxication.
- confusional state
- Delirium
- Night terrors and sleepwalking.
- Psychogenic twilight states, psychogenic fugue, and dissociative state.
- Multiple personality
- Disorientation (self and allopsychic)
- Asthenic/apathetic state.
- Partial alterations of consciousness.
- Depersonalization.
- Derealization.
- Altered body awareness:
- Anosognosia.
- Astereognosis.
- Prosopagnosia.
- Phantom limb.
Definition of the different clinical concepts:
Clouding:
Slight weakening of consciousness. The individual only reacts to stimuli of greater intensity than usual. Difficulty concentrating, slowed thinking, attentional lability, and fatigability.
Blunting:
The impairment is more profound. Stronger stimuli are needed. Perception is impaired. Voluntary actions are reduced.
Sleepiness:
The subject exhibits a state with a strong tendency towards hypnic behavior. Constant and intense stimuli are required. Episodes of excitability and irritability may occur.
Drowsiness/stupor:
Alertness is only achieved for short periods of time and through very intense stimuli. It is considered the state of consciousness immediately preceding coma. Classically, a distinction was made between the psychogenic stupor – present in psychiatric pathologies – and the organic stupor– present in neurological pathologies. Psychogenic stupor could, in turn, be hysterical or catatonic.
Eat:
Global suspension of consciousness
Hypervigilance/hyperphrenia/ecstasy:
It is characterized by an increased level of alertness or clarity of consciousness, usually accompanied by increased distractibility. It commonly occurs with the use of certain drugs and in manic states. Some authors include the ecstasy such as states of hypervigilance and are characterized by immobility, beatific or joyful expression and sensory inaccessibility.
