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Talk:Thought disorder

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Wow
This is a horrible and misinformed article, it sounds like whoever wrote it has based their knowledge of mental illness on what they've picked up from watching The Dark Knight 13 times. Don't try to give your own examples if you have no idea what you're talking about. —Preceding unsigned comment added by 71.226.184.63 (talk) 02:47, 16 February 2010 (UTC)

No seriously, this article reads like an example of Circumferential speech as it's defined here. This needs a clean up, badly. 69.232.239.205 (talk) 07:17, 31 July 2010 (UTC)

^Thirded. It's vague, judgemental, and confusing. 82.9.107.110 (talk) 20:23, 23 September 2010 (UTC)

Forthed, probably. This article reads like it was written by an idiot. —Preceding unsigned comment added by 110.174.11.78 (talk) 17:03, 7 April 2011 (UTC)

My issue with this article is that it doesn't give other explanations for many of these "symptoms". My family has no history of spectrum disorders; stilted speech was just a big part of our humor. More often than not it signified deeper emotions. For example: "I considered the professor's analysis of my endeavors to be somewhat unCOURteous!" is Yankee for, "What a jerk!!") Or it might be facetiously self-deprecating: "This bread pudding is so good!" "Yes, well... widely known, am I, for my delightful day-old delicacies. 'Le Roi de la Pud au Pain!' they whisper in reverence." Which meant, "I'm glad you like it but it's just bread pudding." Etc. etc. Yet again, the internet insists on zebras when horses will suffice. Grammargal (talk) 15:11, 26 October 2012 (UTC)

ELLA'S
ELLA’S COMPETENCY PRINCIPLE "At 6 months of age Ella revealed the brain was just an organ that could collect the right information or the wrong information and usually is assisted by the environment to collect the right information. She did this by demonstrating competency at [say] opening or closing her mouth when tasty or pungent food was offered. She revealed an incompetency at drinking from a cup however. She would grasp the cup, in the same way she grasped a toy, but licked the bottom and sides in preference to drinking from it. By the time she was 12 months old she was competent at drinking from the cup. Furthermore the sides and bottom now did not interest her. A person who has not learnt to be competent is said to suffer from a mental illness to some degree. I consider this attitude to be unprofessional to the point of abuse. For example, try to explain the following:- The dispersion or variation in a distribution, equal to the square root of the arithmetic mean of the squares, of the deviations from the arithmetic mean. In some respects, the reader is like Ella trying to “understand” the cup. It will take quite a lot of effort to be competent to recognize ‘standard deviation’ in its various forms. A lot of evidence is incompetent evidence. Because the omissions, fallacies and manipulations it contains are beyond the comprehension of most people, it often reads like a plausible statement or the reader writes it off as beyond their level of expertise. However, some people do make an inner directed adaption. A person is inner directed when they believe their thoughts, knowledge, values etc., are better than external ones. In a few isolated cases, this is true. For example, whoever said the world was round when the logical uneducated response is to say it is flat, reveals an outstanding level of insight. Most people who are inner directed are or become incompetent to some degree. These people are often stigmatized as mentally ill, instead of diagnosed as having a knowledge deficit". I have not referenced the quote as most dictionaries give the same definition - therefore it does not contain substantial originality, plus it only describes a common mathematical principle {© LEEDS, The Breadperspective 2007}.

Hi there,

I've replaced the original initial sentence of this entry.

In the case of this entry the construction "thought disorder or formal thought disorder is a symptom of psychotic mental illness" suggests a confidence that we do not currently have in being able to define this symptom.

What thought disorder actually is, is an incoherent definition for a symptom of mental illness (see 'Diagnostic Issues' section). Something cannot be a symptom of mental illness and an incoherent definition for one.

Similarly, in science definitions may change over time, may be used in subtly different ways or there may be several competing theories as to what the actualy phenomena really is. Therefore the simpler construction is misleading as it suggests Wikipedia is able to precisely define the term. The term does not adequately define the phenomena, it refers to its general properties of common usage.

"A dog is not a TERM TO DESCRIBE an animal; a dog is an animal" is a little bit of a red herring as 'dog' is a concrete noun and hence the understanding of what it refers to is unlikely to change.

-- [[User:Vaughan|Vaughan]

Diagnostic Issues - NPOV
"The concept of thought disorder has been criticised as being based on circular or incoherent definitions. For example, thought disorder is inferred from disordered speech, however it is assumed that disordered speech arises because of disordered thought. Similarly the definition of 'Incoherence' (word salad) is that speech is incoherent."

This doesn't seem to be a valid criticism. E.g., "For example, lack of light is inferred from darkness, however it is assumed that darkness arises because of a lack of light." This is a perfectly reasonable statement. If we have a premise that X arises because of Y, then inferring Y after observing X is valid.--Simoes 07:08, 4 Sep 2004 (UTC)

Idiots. There is no such thing as a NPOV. It is itself a delusional concept, that is as absurd in reality, as the idea of a absolute center of the universe. Position is relative. And so is perceived reality. Therefore, nobody is able to define an absolute true reality, as it does not exist. Not even time and space itself is absolute. The only people who would make a definition like that, are those who are incredibly egocentric and arrogant, and live in the delusion of the whole world revolving around them. I.e. the Wikipedia admins. — 88.77.186.3 (talk) 06:46, 25 January 2011 (UTC)

Some of the described language disorders are very common in autism and Asperger Syndrome. A recent study in Finland of adults attending an out patient clinic, 4 to 6 % were newly reassessed has having an autism spectrum condition, a third of those were previously misdiagnosed with schizophrenia. Sz diagnosis are often made on the bases of unusual speech patterns, social isolation and flat effect.

I have AS myself, I’m for example highly tangential. In the book, Eccentrics, Jamie James presented analyses the speech patterns of eccentrics (about half of who imho had AS /autism) and found that half subjectively fitted the language patterns of schizophrenia. On objective analysis, their speech patterns were more obsessive, there was much less derailment and loss of goal than normal individuals and far less than Sz. Even if eccentrics were on the surface highly illogical and tangential (in common with Sz), every eccentric returned to the initial subject question “via a highly circuitous route”. Also, in eccentrics, suggesting they had autism (a developmental delay) used "I" as often as children and many exhibited pronoun reversal, using we instead of "I" or referring to themselves by their first name.

Speech of autistics...

Pressure of speech - V. Common, esp. in High Functioning Autism (HFA) Distractible speech - Common, often due to special interest, the person collects ties. Neologisms - Very common Circumstantiality - Common Echolalia - Very common, particularly in HFA Stilted speech - Very common, pedantic speech is thought by some to distinguish AS Self-reference - Very common, autism is a developmental delay after all Word approximations - common Tangentiality - seems tangential but not, obsessive Loss of goal - less than normal subjects

As such, I would like to see a reference to Autism and it’s speech idiosyncrasies.

Diamond Dave 18:56, 4 Sep 2004 (UTC)

 * Hence my edit condemning this article as it is not an inherent function of psychosis, but it appears in psychotic disorders. This disorder is very consistant with Autism and Autistic Spectrum disorders, and not just psychosis; I'm putting an NPOV tag up on this article for lack of explanation about how this relates to autism, if it does at all, and why it "doesn't" as there might be people out there like me running around doing things in this particular article, and there might be someone thinking that people like me are schizophrenic/psychotic because we go on tangents.

 * Also, topic of interest, puns: I make a lot of them, and they're very intentional, as I find them humorous. If anything, it should state unintentional punning, for example.  Is this a problem of formal thought disorder?  Or is it a problem of autistic spectrum disorders?  Or is it a sense of humor and little more?  More clarification is needed.J. M. 08:26, 27 May 2006 (UTC)

 * Hi there,

 * Formal thought disorder typically refers to thought disorder present in psychosis (see books on descriptive psychopathology - I recommend Sims; ISBN 0702026271). This does not mean similar phenomena can't be present in people with other diagnoses, it just means it wouldn't be labelled as formal thought disorder (compare with aphasia). This is also why the criteria include everyday activites such as punning.

 * Your objection is like saying that you sometimes make actions like a ballet dancer, but as you're a gymnast, the ballet article must be NPOV.

 * - Vaughan 14:01, 27 May 2006 (UTC)

 * See, there's something notable here: I'm criticizing lack of criticism into it. Look at ADD/ADHD articles, and look at anti-psychiatry, or dopamine theory of psychosis.  I am saying that there are disorders that mimic this, and that it should include mention of things that mimic this for further research and study.  Lack of mentioning Asperger's, for instance, is inapproriate even if it doesn't fit the definition.  As far as I'm concerned, the comparison is creative, but inappropriate since there are clear understood boundries between a ballet dancer and a gymnast.  However, I am stating that the boundries between this and what I suggest, as well as Diamond Dave aren't so clear cut, and there may be studies out there to prove it.  If the misdiagnosis on such a scale is true, it suggests-strongly-that this definition is invalid unless it is called "Formal Thought Disorder of Psychosis" and adding "Formal Thought Disorder of Autism" or something, clearly hilighting why it can not be something that's pretty much the same thing or simply scrapped.  I would add that several definitions are too limiting, and are very commonly changed.  It also is of considerable note that Autism was once referred to as "Childhood Schizophrenia"-not, once again, if Autism is considered schizophrenia (Which it is not and in fact it is very different) then clearly it fits these guidelines, hypothetically.  The point is there are clear overlapping traits, though clearly not all traits are in the other (Autistics don't hallucinate based on autism but only if they have another disorder, and schizophrenics don't have these symptoms that mimic negative schizophrenia (alogia, emotional flattening)/formal thought disorder until later in life).J. M. 07:20, 28 May 2006 (UTC)

 * And I think it needs to be said: You aren't the only one who has an opinion, or even information on this topic and I would caution you from acting as if you are. It is highly insulting and not in the spirit of wikipedia.  It is acceptable to prevent wrong information to go in.  However, it is unacceptable to remove other people's tags without a discussion of why they're there.  As far as I'm concerned, this article is extremely POV because it is extremely selective of what information is in there.  It only talks about psychosis and schizophrenia.  It doesn't talk about similar disorders, and how it is different aside from the fact it is simply defined as psychosis.  If someone is researching something, it might make them miss the correct information as it is censored.J. M. 07:32, 28 May 2006 (UTC)

 * And, even similar, you mean to tell me that you're such an expert that these disorders can't be all linked? That seems a bit dubious.  For instance, lets say I cut my arm and I break my bone.  They'll both hurt.  But the point is, the problem is ON MY ARM.  You can say a cut is a cut and a broken bone is a broken bone, but an arm is an arm.  But lets say that the cut is on my leg and my arm is broken.  Then it is two different things, distinctly.  I don't think there's enough information availible to say why that the causes aren't similar, or possibly the same.  That's the point.J. M. 07:37, 28 May 2006 (UTC)

 * Hi there,

 * Please add the information that you feel would balance the article (with references please).

 * - Vaughan 09:26, 28 May 2006 (UTC)

 * Knowledge of Autism Spectrum Disorders (ASD's) in adult psychiatry is very poor...autism in the 70’s and 80’s was thought to be (when most practicing psychiatrists were educated) a rare and severe “childhood” condition. Beginning in 1981 and particularly after 1994 (with DSM-IV), the understanding of ASD’s has changed radically to encompass a wide spectrum, from severe Kanner’s Autism to a personality type seen in Asperger’s Syndrome (Which now represents 60% of ASD's and ~0.5% of the general population; schizophrenia I believe is 0.5 to 1%?). This realisation is shaking psychiatry to its foundations, it is causing much friction and difficulty. I was told by a psychologist friend (an expert on ASD’s) that the DSM should be thrown away because various personality disorders e.g. OCD personality disorder, avoidant personality disorder, social phobia; are various expressions of ASD’s in adulthood. The differing opinions seen in Wiki reflect this change, so lets be patient.

 * -Diamond Dave - 15/06/2006 15:09 UT

"And, even similar, you mean to tell me that you're such an expert that these disorders can't be all linked? That seems a bit dubious.  For instance, lets say I cut my arm and I break my bone.  They'll both hurt.  But the point is, the problem is ON MY ARM.  You can say a cut is a cut and a broken bone is a broken bone, but an arm is an arm.  But lets say that the cut is on my leg and my arm is broken.  Then it is two different things, distinctly.  I don't think there's enough information availible to say why that the causes aren't similar, or possibly the same.  That's the point." - Another way of viewing this though is that the FUNCTIONAL impact of your cut and your fracture may be the same, given the location - ie pain, reduced mobility etc. But what you'd do for each injury might be very different, and they may not have had the same cause. It's true that they MAY have, and their being in the same 'place' could make this more likely - but then to further your analogy, if you've been kicked in the arm by a horse and sustain a fracture AND an overlying laceration, that's NOT the same cause as if you fell and broke your arm and then cut your arm with a knife in a separate incident. May look the same, but would have a different cause. Psychiatric disorders may be like that (and given the complexity of the 'machinery' involved they likely have multiple common features) - but there IS the possibility that they just express some similarities in phenotype BECAUSE of the common machinery (ie the brain) that they use. Carly 203.166.230.84 16:57, 29 September 2006 (UTC)

"Thought disorder" vs "Formal thought disorder"
Hi. Thought disorder redirects here, but is "thought disorder" really the same as "formal thought disorder"? My Swedish dictionary of psychology differentiates between two kinds of thought disorder: This website, randomly found with google, says that "Formal Thought Disorder is a Disorder of Thought, but not all Disorders of Thinking are Formal Thought Disorder". What do you think? /skagedal[talk] 17:37, 20 February 2006 (UTC)
 * formal thought disorders such as thought deprivation, neologisms and flight of speech; and
 * content disorders such as delusions, megalomanic or paranoid ideas, etc.

 * Hi Skagedal,

 * What you describe is a common distinction made in psychiatry, so you're quite right. However, 'formal thought disorder' is typically abbreviated to 'thought disorder', although perhaps the article should contain some text that warns the reader of this ambiguity.

 * - Vaughan 20:33, 20 February 2006 (UTC)

 * You might want to review your thinking on this subject in the light of The Cambridge Handbook of Thinking and Reasoning By Keith J. Holyoak, Robert G. Morrison - specifically but not only based on the heading Defining Thought Disorder and then on the following quote from Kleiger "Apart from the circular conclusion that thought disorder scores tell us that a person has a “thought disorder” or “impaired reasoning,” what do they actually mean in terms of how an individual perceives the world, interacts with others, or feels ..." where he imagines a specific meaning in his Rorschach index. It seems to me that the interpretation of the phrase thought disorder has fallen exclusively under what one might distinguish as thought disorder (psychiatry) or formal thought disorder vs thought disorder (psychological assessment) ... of course this still doesn't resolve the more germane question of whether if a thought disorder is inferred from problems in speech whether the phrase has any epistemological value at all --Suidafrikaan (talk) 21:08, 5 April 2016 (UTC)

Knight's move
What's illogical about the way a knight moves in chess? Could we have a better word, please - non-linear, perhaps? --Khendon 21:05, 1 March 2006 (UTC)

 * I've been thinking the same thing. How about "discontinuous"? /skagedal... 11:40, 2 March 2006 (UTC)

 * Knights Move is the official description of this language error. However, I would like to point out that it very common in Asperger's Syndrome Asperger’s Syndrome, I have witnesses this myself. People with AS are often obsessed with unusually intense and narrow intellectual interests and in conversation they will (depending on how affected they are)...suddenly switch a conversation to their obsession, with little regard to the listener. It is quite jarring and sudden. For example

 * Me - “how was your day?”, friend with AS – “Fine, I got into college at 10am. Did you see any mechanical diggers? I did, I saw 4 mechanical diggers, I don’t know why workers don’t uses shovels anymore.”

 * My friends obsession is mechanical diggers but I worry that a psychiatrist unfamiliar with AS would see the Knights Move = thought disorder. My other AS friends are into...the Titanic, The Beatles, films. In all cases conversations switch suddenly to one or between several different subjects. I’m quite disturbed by this, as the Knights Move was said to be a very reliable and unique attribute of a thought disorder. And thus, a good indicator of schizophrenia.

 * - Diamond Dave- 15/06/2006 15:32 UT

It's important not to get too distracted by the association between formal thought disorder and schizophrenia, as demonstration of the former is NOT pathognomonic of the latter. Bipolar affective disorder (in particular the manic phase) frequently displays phenomena outlined in this article as formal thought disorder, for example circumstantiality and tangentiality - but it is a totally different clinical entity to schizophrenia. Displaying formal thought disorder doesn't automatically earn the label of schizophrenia in the clinical setting, it is more indicative of psychosis in general (with whatever underlying cause). Incidentally pressured speech is often not referred to by clinicians as "formal thought disorder" but thought more to be a sign of the underlying symptom of racing thoughts (commonly described by and found in manic patients). It is also observed in a separate category of the mental state examination (which by one commonly used model goes Appearance/Behaviour, Speech (where pressure is noted), Mood/Affect, Thought (both form and content), Perception, Intelligence/Cognition, Rapport, Insight/Judgement).
 * I freely admit this is opinion, observation and experience based on study and working as a psychiatric resident at a hospital for three months, but I can heartily recommend reading both the DSM-IV and moreover a great text by Kaplan & Sadoch for accurate but accessible descriptions of the terms and their associations. 203.166.230.84 16:44, 29 September 2006 (UTC)Carly

Phonemic paraphasia Example
Can someone explain this to me? "Phonemic paraphasia - Mispronunciation; syllables out of sequence. e.g. "I slipped on the ice broke my arm". What syllables are out of sequence? All I note is the missing 'and'. Did some confused wikiknome 'correct' the spelling? Ed 21:24, 7 April 2006 (UTC)

 * I originally thought what it was saying is that the two sentences "I slipped on the ice" and "The ice broke my arm" got melded into one. But that doesn't fit with the definition at all, and having checked the history of edits, it seems Drrngrvy changed the word "lice" to "ice" on March 28. I'm pretty certain lice was intentional, seeing as it was in the very first version of the article, so I'm changing it back. :) JulianDalloway 15:53, 24 April 2006 (UTC)

 * Syllables out of sequence? Wouldnt that be, for example, like taking the word banana and saying it "nabana" or some such? Muddling up the syllables of a word? —The preceding unsigned comment was added by 71.192.42.69 (talk) 02:10, 20 December 2006 (UTC).

Distinctions, additions, 'see also', redundancies and tabulation
The article could distinguish between:
 * disturbance of a) content or b) form (well set out in Kaplan & Sadock), where formal thought disorder refers to the latter
 * thought and speech disorders
 * thought disorders vs logical fallacies
 * thought disorders as symptoms vs formal disorders as identified in DSM-X/ICD-X
 * thought, language, and speech

The following list, may help to expand the section on specific subtypes. Some of these:
 * already occur in the list but are listed for the sake of completeness
 * occur in the text but not in the list
 * already have wikipedia entries
 * require disambiguation
 * need articles of their own, or
 * should be included in a 'see also' section.

Annotated list (which is alphabetized)

 * Agrammatism
 * Akataphasia
 * Alexithymia
 * Alliteration (psychiatry) vs Alliteration and Assonance
 * Alogia
 * Anomia vs Dysnomia
 * Aphemia vs Mutism
 * Asperger’s syndrome (AS)
 * Autistic thinking
 * Blocking, Blocking (psychopathology), thought blocking and Blocking effect
 * Bloviate
 * Brain fog
 * Cantinfleada or Cantinflassing
 * Circumstantial thinking vs Circumstantiality
 * Clang associations or Clanging
 * Clanging
 * Clouding of consciousness vs Brain fog
 * Cluttering or Tachyphemia
 * Cognitive slippage
 * Condensation vs Condensation (psychopathology)
 * Confabulation vs (Mythomania or Pseudologia fantastica or Pathological lying
 * Coprolalia
 * Déjà pensé
 * Déjà vu
 * Delusions
 * Demagoguery
 * Dementia
 * Depersonalization
 * Derailment - vs Derailment (psychiatry), Flight of ideas vs Knight's Move thinking vs Tangentiality
 * Derealization
 * Dereistic thinking
 * Distractible speech
 * Doggerel as a symptom of Asperger’s syndrome
 * Écho de la pensée - hearing voices that echo one's thoughts
 * Echolalia
 * Elegant variation
 * Fantasy
 * Flight of ideas - switching topic mid-sentence or inappropriately
 * Gedankenlautwerden
 * Glossolalia - speaking in tongues
 * Grandiloquence
 * Hallucinations
 * Hypergraphia
 * Hyperlexia as a symptom of Asperger’s syndrome
 * Ideas of reference or Sensitiver beziehungswahn
 * Idée fixe
 * Illogicality
 * Illusion
 * Impoverished thinking
 * Incoherence (word salad) vs Incoherent speech
 * Intrusive thoughts
 * Jargon aphasia
 * Literal interpretation as a symptom of Asperger’s syndrome
 * Logic error in programming vs Logical fallacy neither of which, strictly speaking, is pathological
 * Logoclonia
 * Loose associations vs Asyndesis vs Entgleisen
 * Loss of goal
 * Magical thinking
 * Negative thinking and Negativisim colloquially; not to be confused with Negativism in psychiatry vs Rumination
 * Neologism or *Coinages specifically as a symptom of Asperger’s syndrome
 * Obsessive thinking
 * Odd beliefs
 * Palilalia - repeating one's own words
 * Paranoid ideation vs Delusion and Paranoia
 * Perseveration in speech as opposed to peers such as Palinacousis and Palinopsia
 * Phonemic paraphasia
 * Pleonasm
 * Positive thinking - pop psych
 * Pressure of speech - speaking incessantly and quickly
 * Prolixity
 * Punning or Foerster's syndrome
 * Redundancy
 * Rhyming
 * Rumination - negative cyclic thinking, persistent and recurrent worrying or brooding
 * Scanning speech
 * Schizophasia
 * Self-reference
 * Semantic paraphasia
 * Speech disorder and the overlaps with some of its types
 * Spoonerism eg "I want a tub of not poodles" - should this be added? —Preceding unsigned comment added by 86.145.207.159 (talk) 08:18, 9 August 2010 (UTC)  See bullet 5 --Suidafrikaan (talk) 20:46, 5 April 2016 (UTC)
 * Stilted speech – which is classified as a speech disorder
 * Suicidal ideation
 * Tangential thinking or tangentiality
 * Telegraphic speech or Telegrammatic speech
 * Thought insertion
 * Thought sonorization vs Gedankenlautwerden vs Echo de la pensee
 * Thought withdrawal
 * Train of thought
 * Unusual juxtapositions as a symptom of Asperger’s syndrome
 * Volubility or Logorrhoea or or Loquaciousness vs to wit at least verbal diarrhea
 * Vorbeigehen vs Vorbeireden
 * Witzelsücht vs Schadenfreude
 * Word approximations
 * Word play as a symptom of Asperger’s syndrome, and which offers a handy list for distinguishing between quirks of language (e.g. Malapropism and Onomatopoeia) vs thought and speech disorders
 * Word salad or Schizophasia or Wortsalat
 * Wurgstimme

On the subject of redundancies: Several of these terms are already defined in the arbitrary, nebulous and AfD-worthy wikipedia entry Glossary of psychiatry

Tabulation
We might also consider producing this list in tabular form with a column for the psychiatric illnesses with which these various symptoms are associated.

Suidafrikaan 03:24, 7 June 2007 (UTC)

Bullet 5 Consider the following from the present version: "Semantic paraphasia – Substitution of inappropriate word. e.g. "I slipped on the coat, on the ice I mean, and broke my book."" How does this differ from a Spoonerism?--Suidafrikaan (talk) 20:51, 5 April 2016 (UTC)

Important point about when it is a disorder and when not!
When you look at the list, you notice that emotional people, and especially women behave like that often. (E.g. “Then there was this guy who… Ooohhh, shoooeees!“ or talking a lot.) BUT: This does not mean that it is a disorder, nor that those people are ill/worse/inferior/etc! I am highlighting this, because in the past, this reasoning was used by people of my gender against women, to act as if they were somehow inferior. The modern view is, that something is only a disease, if it it detrimental to the person having it. Of course as you can see, in most cases most of the listed points are not detrimental but even beneficial behavior. There is a gradient. And diseases usually require an extreme level. As a very emphatic person myself, and from studying the subject, I know that this is simply a different way of thinking in the non-pathological cases. For example, there in nothing wrong with suddenly being distracted by something interesting. And when women talk a lot to each other, that is simply a form of showing affection and sympathy. Unfortunately, it still gets – often deliberately – misinterpreted as a inferiority, sometimes even by women themselves. I think we should therefore make it very clear, that what makes a disorder and what not, is not for the not understanding to judge, but is only definable by those being able to properly judge if it is detrimental. This is also the reason the law is defined in such a way, that you can’t force a mentally ill person to get a therapy, if that person states that he/she is feeling well, and he/she does not harm anybody. – 88.77.186.3 (talk) 06:41, 25 January 2011 (UTC)

 * Take this to its logical conclusion and one should realise that there are no "disorders" at all, but merely differences from one to the next. As it stands though, it just seems like you're trying to substitute your own subjective values in place of whatever more generalised values were held by the article creator.
 * Unfortunately perhaps, communication relies on categorisation (which is frequently, if not always, inappropriate and inaccurate) and simplification of data by the removal of details. Which details are key and which are trivial vary from one to the next... but if data is not simplified then it cannot be processed. Or to put it another way: whoever wrote the article probably wasn't trying to offend you or anyone like you, but rather failed to even consider such an eventuality because the thought would have been superfluous at the time... just like if you build a car, you don't usually put in elephant-trampling countermeasures because chances are your car will never be trampled by elephants.
 * Yes... what this means is that people who "think differently" are inconsequential trivialities to neurotypical society, as no matter what they randomly decide to call us, most of them will never suffer any ill consequences of said choice because we are quite clearly not the majority (and therefore don't really get a say). ~ SotiCoto (talk) 14:01, 23 March 2011 (UTC)

Some "symptoms" just a result of "not being an idiot".
I typically find a fairly smooth correlation between a person's apparent intelligence and the effective topic "leaps" I can make in talking to them. Indeed, one can find that more cognitively canny sorts will generally communicate in a more complicated and potentially abstract manner than the simple-minded. Heck, claims of illogical thought patterns seem to rather blatantly indicate significant disability on the part of the listener to fill in the gaps themselves through simple deduction, or else a reluctance to ask or wait patiently for the connector. It is just a levelled-up form of the typical imbeciles who keep demanding I "not use big words". Just to justify, I may be Aspergian, but a close friend of mine is not and we can communicate quite easily because she is also an intelligent and logical thinker with an expansive vocabulary. Conversely, many others I've encountered have displayed varying levels of bewilderment at my mode of exposition, some to the point where they understood nothing if it wasn't read out to them like a child's first book. ~ SotiCoto (talk) 14:20, 23 March 2011 (UTC)

Inability to use Aristotelian logic?
The opening has the following sentence: "However, there is a vague clinical difference between the two. Schizophrenic or psychotic patients are less likely to demonstrate awareness or concern about it [5] because it results from a fundamental inability to use the same type of Aristotelian logic as everyone else does[6] whereas so-called “organic” patients with a clouded consciousness usually do demonstrate awareness and concern about it, by complaining about being “confused” or “unable to think straight” because it results, instead, from various cognitive deficits.[4]"

Schizophrenics have a "fundamental inability to use Aristotelian logic that the rest of us do?" This is nonsense. Aristotelian logic is one form of logical system that used to be used, but has now been superseded by predicate logic amongst logicians, as it was a formal system that had a great deal of problems (for instance, it had difficulties with empty sets). I would be surprised if there was some inability to use this antiquated formal system amongst schizophrenics, or if the typical persons reasoning process in any way actually resembled parsing Aristotelian logical statements (if so, again, there are superior logical systems out there, and they are using a poor one that is really only still taught for historical reasons). Either someone who read this source did not understand what they were reading, or the source itself was just throwing out a hard science concept they had little real understanding of in a thinly veiled attempt to boost their credibility, as is so common among the soft sciences.68.19.233.157 (talk) 02:58, 23 January 2013 (UTC)

Self-Reference
The article identifies "inappropriate self-reference" as a symptom of thought disorder, but it links to Self-reference, which is about the general phenomenon of self-reference. Either there should be a separate page for self reference as a symptom of a thought disorder, or this link should just be removed. Nosewings (talk) 18:48, 28 June 2013 (UTC)

INFORMAL THOUGHT DISORDER
© The BreadPerspective, Christine Leeds 2003-2014.“People or animals are 'childlike' and occasionally have an INFORMAL thought disorder. For example, a child thought his skin is brown because he was born in Brisbane. One or more people in his environment challenged his internal belief so reality set in. If beliefs like these are not challenged then they are at risk of developing a FORMAL thought disorder. For example, they might select people who have brown skin. As a consequence, they might regard their next door neighbour as their kin because he has brown skin and not regard their brother as kin because he has white skin. Because other people do not do the same, he is then said to have a mental illness. This is a human/adult problem, in nature animals rarely have mental illnesses” © The BreadPerspective, Christine Leeds 2003-2014. — Preceding unsigned comment added by 122.108.183.252 (talk) 23:40, 1 March 2014 (UTC)

cofusion of examples
I find it useful that you give examples of a typical interaction with a person with a certian disorder, however It seems that the example of echolalia is acctually an example palilalia. I looked up the articles on both and the example in the article about echolalia is very different from this article. The example on this page goes as follows:

"What would you like for dinner?", "That's a good question. That's a good question. That's a good question. That's a good question."

while the example on the echolalia page goes like this:

a child is asked "Do you want dinner?"; the child echoes back "Do you want dinner?", followed by a pause, and then a response, "Yes. What's for dinner?"

could someone cosider fixing this?--Quiet Wanderer (talk) 00:10, 18 October 2014 (UTC)

I made changes and added to the echolalia definition under the 'Types' subtitle. Jaycar71 (talk) 19:26, 12 July 2021 (UTC)

Diagnosis - should be removed
The entire section seems irrelevant. It is composed of 1 section containing nonsense: td is inferred from one symptom. ok, so what? If there is a criticism then what is it? That not all td sufferers have that symptom, or not all those symptomatic have td? Ridiculous nonsense. Another section comments about the potential of misdiagnosis. But td is NOT a diagnosis! Hence the comment seems irrelevant, and of course this fact is the crux of the problem with this section: thought disorders are symptoms of diagnosable disorders, they aren't in and of themselves "diagnoses". The third topic is AS, and is afaics totally irrelevant here, also. SO WHAT if autism correlates to dt? Make a point or remove the language. The basic problem is that this section has no purpose in advancing the article.216.96.76.190 (talk) 17:43, 16 December 2014 (UTC)
 * Put some more text that may address some of these problems, except the bit about autism, which is still left there. --Tikmok (talk) 11:55, 4 January 2020 (UTC)

References in the "Types, Signs, and Symptoms" section
One of the problems with references in this section is it's unclear if a reference covers:
 * 1) who classifies the said "subtype" as a thought disorder
 * 2) who defines the subtype
 * 3) who gives an example

I've started tagging references next to the subtype names to indicate who classify the subtypes as thought disorders. Just in case anyone wonders why. --Tikmok (talk) 11:31, 4 January 2020 (UTC)

Wiki Education assignment: Human Cognition SP23
— Assignment last updated by Serenity D-B (talk) 20:03, 27 March 2023 (UTC)

title: Talk:Thought disorder


text:
United States federal executive departments

The United States federal executive departments are the principal units of the executive branch of the federal government of the United States. They are analogous to ministries common in parliamentary or semi-presidential systems but (the United States being a presidential system) they are led by a head of government who is also the head of state. The executive departments are the administrative arms of the president of the United States. There are currently 15 executive departments.

Structure
Each department is headed by a secretary whose title echoes the title of their respective department, with the exception of the Department of Justice, whose head is known as the attorney general. The heads of the executive departments are appointed by the president and take office after confirmation by the United States Senate, and serve at the pleasure of the president. The heads of departments are members of the Cabinet of the United States, an executive organ that normally acts as an advisory body to the president. In the Opinion Clause (Article II, section 2, clause 1) of the U.S. Constitution, heads of executive departments are referred to as "principal Officer in each of the executive Departments".

The heads of executive departments are included in the line of succession to the president, in the event of a vacancy in the presidency, after the vice president, the speaker of the House, and the president pro tempore of the Senate. They are included in order of their respective department's formation, with the exception of the Secretary of Defense, whose position in the line of succession is based on when the Department of War was formed.

Separation of powers
To enforce a strong separation of powers, the federal Constitution's Ineligibility Clause expressly prohibits executive branch employees (including heads of executive departments) from simultaneously serving in Congress, and vice versa. Accordingly, in sharp contrast to virtually all other Western democracies (parliamentary systems) where ministers are selected to form a government from members of parliament, U.S. legislators who are appointed by the president and confirmed by the Senate to serve as heads of executive departments must resign from Congress before assuming their new positions. If the emoluments for a new appointee's executive branch position were increased while the appointee was previously serving in Congress (e.g., cost of living adjustments), the president must implement a Saxbe fix.

Contracting and grantmaking roles
As is evident from the chart below, several executive departments (Education, Health and Human Services, Housing and Urban Development, and Transportation) have disproportionately small employee headcounts in contrast to the size of their budgets. This is because many of their employees merely supervise contracts with private independent contractors or grants (especially categorical grants) to state or local government agencies who are primarily responsible for providing services directly to the general public. In the 20th century, when the federal government began to provide funding and supervision for matters which were historically seen as the domain of state governments (i.e., education, health and welfare services, housing, and transportation), Congress frequently authorized only funding for grants which were voluntary in the sense that state or local government agencies could choose to apply for such grants (and accept conditions attached by Congress), or they could decline to apply. In the case of HHS's Medicare program, Congress chose to contract with private health insurers because they "already possessed the requisite expertise for administering complex health insurance programs", and because American hospitals preferred to continue dealing with private insurers instead of a new federal bureaucracy.

Proposed departments

 * Department of Industry and Commerce, proposed by Secretary of the Treasury William Windom in a speech given at a Chamber of Commerce dinner in May 1881
 * Department of Natural Resources, proposed by the Eisenhower administration, President Richard Nixon, the 1976 GOP national platform, and by Bill Daley (as a consolidation of the Departments of the Interior and Energy, and the Environmental Protection Agency)
 * Department of Peace, proposed by Senator Matthew Neely in the 1930s, Congressman Dennis Kucinich, 2020 and 2024 presidential candidate Marianne Williamson, and other members of the U.S. Congress
 * Department of Social Welfare, proposed by President Franklin D. Roosevelt in January 1937
 * Department of Public Works, proposed by President Franklin D. Roosevelt in January 1937
 * Department of Conservation (renamed Department of the Interior), proposed by President Franklin D. Roosevelt in January 1937
 * Department of Urban Affairs and Housing, proposed by President John F. Kennedy
 * Department of Business and Labor, proposed by President Lyndon B. Johnson
 * Department of Community Development, proposed by President Richard Nixon; to be chiefly concerned with rural infrastructure development
 * Department of Human Resources, proposed by President Richard Nixon; essentially a revised Department of Health, Education, and Welfare
 * Department of Economic Affairs, proposed by President Richard Nixon; essentially a consolidation of the Departments of Commerce, Labor, and Agriculture.
 * Department of Environmental Protection, proposed by Senator Arlen Specter and others
 * Department of Intelligence, proposed by former Director of National Intelligence Mike McConnell
 * Department of Global Development, proposed by the Center for Global Development
 * Department of Art, proposed by Quincy Jones
 * Department of Business, proposed by President Barack Obama as a consolidation of the U.S. Department of Commerce's core business and trade functions, the Small Business Administration, the Office of the U.S. Trade Representative, the Export-Import Bank, the Overseas Private Investment Corporation, and the U.S. Trade and Development Agency
 * Department of Commerce and the Workforce, a merger of the Department of Commerce and the Department of Labor proposed in 2011 and 2013 by Senator Richard Burr (R-NC) in
 * Department of Education and the Workforce, proposed by President Donald Trump as a consolidation of the Departments of Education and Labor
 * Department of Health and Public Welfare, proposed by President Donald Trump as a renamed Department of Health and Human Services
 * Department of Economic Development, proposed by Senator Elizabeth Warren to replace the Commerce Department, subsume other agencies like the Small Business Administration and the Patent and Trademark Office, and include research and development programs, worker training programs, and export and trade authorities like the Office of the U.S. Trade Representative with the single goal of creating and defending good American jobs
 * Department of Technology, proposed by businessman and 2020 Democratic presidential candidate Andrew Yang
 * Department of Children and Youth, proposed by Marianne Williamson
 * Department of Culture, patterned on similar departments in many foreign nations, proposed by, among others, Murray Moss and Jeva Lange

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


text:
John Davies (runner)

John Llewellyn Davies (25 May 1938 – 21 July 2003) was a New Zealand Olympic bronze medallist and president of the New Zealand Olympic Committee (NZOC).

Biography
Davies was born in London, England, to Welsh parents, and in 1953 moved to New Zealand with his family. The family settled in Tokoroa. He won a bronze medal in the 1500 metres at the 1964 Tokyo Olympic Games, and a silver medal in the one mile event at the 1962 Commonwealth Games in Perth.

Davies retired due to long-term injuries, and after that coached middle- and long-distance athletes, including 1976 Olympic 5000 m silver medallist Dick Quax, 1982 Commonwealth Games 3000m Gold Medalist Anne Audain who also broke the World 5000m record the same year. 1992 Olympic Marathon bronze medallist Lorraine Moller and 1996 Olympic 800 m finalist Toni Hodgkinson. He also contributed to sport as administrator and television commentator.

In the 1990 Queen's Birthday Honours, Davies was appointed a Member of the Order of the British Empire, for services to athletics. In October 2000, Davies succeeded Sir David Beattie to become the NZOC president. In 2003 he was awarded the Leonard Cuff medal by the International Olympic Academy for promoting olympism, only weeks before he died of melanoma.

title: John Davies (runner)


text:
Talk:United States federal executive departments

What is the principle behind the list order?
Hello. I sense that there must be some principle behind the order in which the current departments are listed, but whatever it is, it isn't obvious to me. Is it the order of Presidential succession of the heads of the departments? Might it be worth adding a little explanatory note to the article? DSatz (talk) 09:56, 23 June 2019 (UTC)
 * Order of presidential succession/Order of departmental formation. Looks like the succession numbers were removed. Veterans Affairs is dated to the Veterans Administration start date. I would assume given the department's status that when elevate to department status that the successor agency's start date isn't kept. Spshu (talk) 20:38, 24 June 2019 (UTC)

A Commons file used on this page or its Wikidata item has been nominated for deletion
The following Wikimedia Commons file used on this page or its Wikidata item has been nominated for deletion: Participate in the deletion discussion at the. —Community Tech bot (talk) 10:06, 25 January 2021 (UTC)
 * Matt Ammon US Dept of HUD.jpg

Requested move 12 January 2023

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: page not moved   Arbitrarily0   ( talk ) 18:33, 27 January 2023 (UTC)

United States federal executive departments → List of United States executive departments – per MOS:LIST and 1, 2, 3. The recently added "Overiew" section can easily be incorporated into the lead. Colonestarrice (talk) 03:03, 12 January 2023 (UTC) — Relisting. Wikiexplorationandhelping (talk) 17:33, 20 January 2023 (UTC)

 * Oppose - As far as I can tell, there isn't a dedicated article on US federal executive departments, and there should be. If the article prose continues to grow and expand, then I'd support forking off the lists in the future. But for now, let's keep it all together at the current title. — Preceding unsigned comment added by BilCat (talk • contribs)
 * I agree with you in principle, that there should be a dedicated article, but there isn't. This page is clearly a list at heart and should be titled that way; it can always be transformed into a proper article and moved back afterwards. Colonestarrice (talk) 19:21, 20 January 2023 (UTC)

 * Support. This article is clearly structured as a list article and the title should reflect that. Rreagan007 (talk) 02:39, 13 January 2023 (UTC)

 * Oppose. It makes no sense to have separate articles on "what is a federal executive department" and "a list of federal executive departments". I normally oppose such splits because whenever the first article is something that is a short list, many editors unfamiliar with the rationale for the split will attempt to restore that information to the first article and so we end up with never-ending edit wars over whether the first article should duplicate the contents of the second.  --Coolcaesar (talk) 06:22, 23 January 2023 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
 * Oppose. I concur with the opposition above me. This article explains the principal federal executive departments of the United States and lists them. There are only fifteen of them, it does not warrant its own listing. Even the pages for the Cabinet secretaries generally list the officeholders on the main Cabinet secretary's page instead of on a separate one. The list is included at the bottom for convenience of general, brief information after the details of the departments. --Mortifeye (talk) 01:43, 24 January 2023 (UTC)

Where's the black ops? 😇 HALO
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 * 5900hkd bochk 182.239.93.198 (talk) 04:04, 17 March 2024 (UTC)


text:
Jordanhill College

Jordanhill College of Education was a higher education college in Jordanhill, Glasgow, Scotland. It opened as a teacher training college in 1921. The college merged with the University of Strathclyde in 1993, becoming its Faculty of Education. In 2012 all educational activities were moved to the John Anderson Campus and the campus closed.

Jordanhill Teacher Training College: 1913–1993
In 1913 Glasgow Corporation agreed a deal to buy the Jordanhill Estate from James Parker Smith, the former Liberal Unionist MP for Partick, and build both a teacher training college and the associated Jordanhill School on the site. After the outbreak of World War I, developments for the teacher training college were put on hold, as the former manor house was taken over as a temporary military hospital.

After the cessation of hostilities, a new building was planned to provide teacher training. With the new school completed in 1920 and the college in 1921, the now Grade B listed David Stow Building facilitated all teacher training provided under the unified University of Glasgow. Centrally funded and with no ties with churches, the college was largely non-residential (two small hostels were built, one in 1921 and the second in 1931); and its range of work was wider.

From 1921 to 1959 the regime at the college changed very little. The Scottish Education Department (SED) authorised only a two-year course for primary teachers, and a one-year post-graduate course for secondary teachers. In addition the college provided in-service courses for qualified teachers. The only important changes both took place in 1931 when the two-year primary course was extended to three years (and limited exclusively to women), and the Scottish School of Physical Education (SSPE) was created to train all the male PE teachers in Scotland.

In 1959, SED approved a Board of Governors and the right for each college to award their own qualifications. In part this was because of expected teacher shortages in the 1960s, with 1,927 students in 1959–1960, the number grew to 2,813 in 1963–1964, reaching a peak of 3,713 in 1975–1976, making Jordanhill at that time the largest teacher training institution in Britain. This expansion far outstripped the capacity of the original 1921 Stow building and college (former manor house) building, and hence an extensive building programme which included the 1961 demolition of the original manor house had to be undertaken, to provide new accommodation (inter alia) for the SSPE and the School of Further Education. Part of the increase in student numbers was due to diversification. In 1964, the college began courses to train students for the youth and community service; in 1967 it began courses for social workers; in 1968 the Glasgow School of Speech Therapy moved to Jordanhill and became the Department of Speech Therapy; and in 1970 all the training of teachers for further education colleges in Scotland was centralised in a School of Further Education. In addition, in-service training expanded rapidly in response to the curriculum reform movements of the 1960s.

The period of expansion came to an abrupt end in 1976, when SED realised that there was an over supply of teachers. The smaller Hamilton College was closed in line with UK national policy, with most of its staff absorbed into Jordanhill. The 1980s brought about the degree level four year degree qualifications, and latterly accreditation under the Council for National Academic Awards (CNAA), with all students hence following degree or post-graduate diploma courses which were externally validated.

Faculty of Education, University of Strathclyde: 1993-2012
Anticipating the end of its independence, in 1991 the college approached the University of Glasgow with a proposal that it should become its Faculty of Education. In 1993, SED escalated the need for a merger with publication of its policy document on funding via the new Higher Education Funding Council. The University of Strathclyde approached the college, and an agreement between both institutions was reached. In 1993 Jordanhill College became the University of Strathclyde Faculty of Education.

With better use of facilities, and an ageing campus at Jordanhill which was highly protected by preservation orders, in 2010 the decision was made to close Jordanhill campus and move all courses to its John Anderson Campus. The academic year 2011-2012 was the last before this move took place.

The archives of Jordanhill College are maintained by the Archives of the University of Strathclyde.

Notable alumni

 * Craig Brown, football player and manager including Scotland national team
 * Tormod Caimbeul (1942–2015), Scottish Gaelic writer.
 * Ray Fisher (1940–2011), Scottish folk singer
 * Mairi Hedderwick, author and illustrator, creator of Katie Morag.
 * Janet Kitz, Scottish-Canadian historian and educator
 * Jackie Knight, cricketer and football player
 * Ian McLauchlan, 43 caps for in rugby union.
 * Gwyn Singleton (1933–2021), dyslexia education pioneer
 * Gordon Smith, cricketer

Redevelopment
Working with Glasgow City Council and Historic Scotland to prepare a plan for the future of the former campus, in March 2015 the university announced a plan to sell the residual 30.9 acre estate via land agents JLL. The "minded-to-grant" planning permission in principle plans propose that:
 * Three-storey David Stow building could be converted for up to 71 residential apartments
 * Graham House and Douglas House could house up to 23 apartments each

The remaining 1960s buildings on the site are recommended for demolition, and then divided into 12 plots could be used to develop up to 364 further residential units.

title: Jordanhill College


text:
Talk:Delirium

Untitled
This article is the subject of a course assignment, between Oct 28, 2019 and November 25 2019. Further details are available on the course page. Assigned student editor(s): 14kl3, Abby.christi, Judypl2023

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 4 March 2019 and 29 March 2019. Further details are available on the course page. Student editor(s): Alulu00. Peer reviewers: Thayermartin.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:15, 16 January 2022 (UTC)

Redirected from "cognitive dysfunction" and "cognitive impairment"
Cognitive dysfunction or impairment needn't be severe (which delirium is stated as being in the intro, although this is contradicted later) and can have gradual onset, whereas this article insists on acute onset. There's obvious overlap in some symptoms, maybe occassionally treatment but I have never heard the type of impairments commonly described as "brain fog" for instance, described as delirium, but perhaps I'm wrong. I think either the delirium article needs to be broadened or more likely there should be a separate article for non-acute generally less severe cognitive dysfunction and/or impairment. Speaking as a lay person the impression I get is that delirium is more often associated with generally severe hallucination-inducing disorders such as high fevers whereas cognitive impairment is more often some degree of attentional or intellectual disability such as some loss of circumstantial problem solving (which could be severe but perhaps more commonly isn't). Vespadrun (talk) 20:52, 28 October 2012 (UTC)
 * "Acute" is defined as "hours to days, but not months or years." Any organic decrease in mentation that develops over years is called "dementia" not delirium. Delirium doesn't have to be severe, and I've corrected that. It can be a "brain fog" like state, and often is. The lay definition that suggests halucination is not correct (or at least, not complete). The medical definition includes all recent-onset cognitive impairments that have an organic cause. Thus, the total spectrum of cognitive impairment is a much broader thing that includes not only delirium, but also many other things that aren't delirium, such as learning and intellectual disabilities (what used to be called mental retardation), various psychiatric problems, effects of dementia, and so on.  S  B Harris 02:27, 29 October 2012 (UTC)

Proposed major revision
On behalf of the European Delirium Association and the American Delirium Society, we'd like to contribute to a major revision of this article. None of us are experienced Wikipedia editors, but we hope it will be a worthwhile endeavour given that this is designated 'high importance' but class-C article.

Proposed addition
My plan for editing the article on delirium is adding a section under prevention that outlines the goals of the HELP organization in the prevention of delirium and highlights some of the research that they have done. Ariellarose19 (talk) 21:18, 15 November 2023 (UTC) Proposed article structure Initial (including clinical importance of delirium) Definition Clinical importance by setting and predictors of outcomes
 * DSM v ICD
 * Why delirium is the preferred term
 * Delirium on the spectrum of acute brain dysfunction
 * ICU
 * Hospital
 * Post-operative delirium
 * Institutional care
 * Palliative care

Signs and symptoms (Rewritten with contribution from David Meagher, 10.12.12) Pathophysiology Causes (added 8.2.13) Prognosis (added 20.11.12) Diagnosis in different care settings Prevention (covering the major RCTs) Treatment (covering the major RCTs) It's likely that we'll need some support as we do this, but we're keen to contribute to (and maintain) the article. The board members of the EDA and ADS number around 35 persons with a multidisciplinary background and experience in research, clinical practice and education, so I think we should be able to offer a balanced article.
 * Inattention and associated cognitive deficits (10.12.12)
 * Higher level thinking processes (10.12.12)
 * Circadian disruption (10.12.12)
 * Prodrome
 * Subsyndromal delirium
 * Persistent delirium (added 06.12.12)
 * Acquired dementia (added 06.12.12)
 * Animal models of delirium (added 12.12.12)
 * Insights from clinical studies (CSF, MRI, EEG) (added 31.01.13)
 * Discussion of the inverse relationship between predisposing and precipitating factors (and the common causes), rather than the rather long list which is ultimately not very informative.
 * Mortality
 * Institutionalisation
 * Dementia
 * Cost
 * ICU (added 06.12.12)
 * Hospital
 * Institutional care
 * Pharmacological
 * Non-pharmacological
 * Pharmacological
 * Non-pharmacological

Please leave any suggestions and advice here. Thanks and best wishes, Dhj davis (talk) 07:03, 13 November 2012 (UTC)

 * I am aware of the project and am very pleased that the EDA recognises the need of a high-quality Wikipedia article on the condition. I will post a message on WT:MED so other editors can watchlist this article and provide support when needed. I agree with the basic structure, which is aligned broadly with WP:MEDMOS. However, I would not use the "classification" section to explain why delirium is clinically important - this is something better done in the introduction and in the prognosis sections. As for "delirium is special settings", perhaps this is best integrated with "signs and symptoms", "diagnosis" and "treatment" insofar possible. JFW | T@lk  08:24, 13 November 2012 (UTC)

 * Thanks JFW. We've taken out the epidemiology section and defined the different settings earlier on, these distinctions can then be referred to in the later sections as you suggest. I'm not sure it's correct procedure to edit back on a talk page, but I thought it would be easier than reproducing the whole outline again. Hope that's OK. Dhj davis (talk) 15:39, 13 November 2012 (UTC)

 * I've added a section (Adverse Outcomes) to test the process a bit, very happy for comments. I know I haven't done the citations correctly, they seem to repeat themselves, but I'll look into this and learn how to fix it. I'm mainly interested in whether the addition is well-received. I should also point out that I'm an author on one of the (peer-reviewed) articles cited, but I hope that doesn't contravene NPOV. Dhj davis (talk) 19:25, 20 November 2012 (UTC)

 * Looks good, but please avoid primary sources in favour of reviews and textbooks. Very recent studies do not necessarily need a mention. JFW | T@lk  00:22, 21 November 2012 (UTC)
 * Thanks JFW, I'll think about the sources. The difficulty is that recent (uncontroversial) studies make the article up to date, but they haven't necessarily filtered through to reviews and textbooks yet. What do you think about actually using 'Uptodate' (the website) as a secondary source?Dhj davis (talk) 12:07, 23 November 2012 (UTC)
 * Bit more to be added today on ICU delirium, from Wes Ely. Dhj davis (talk) 10:20, 6 December 2012 (UTC)
 * And some reorganisation of the phenomenology section from David Meagher (more citations to be added)Dhj davis (talk) 22:06, 10 December 2012 (UTC)
 * I support using UpToDate. Thanks. Sorry I haven't been around to help more. Biosthmors (talk) 22:21, 10 December 2012 (UTC)
 * Applying WP:MEDREV with wise editorial judgement is another option. Biosthmors (talk) 22:23, 10 December 2012 (UTC)

New section on pathophysiology added. I think we'll continue to add some more sections and when all this is complete, I think we could use some help in editing for overall tone and perhaps cutting down the length. One major overhaul I think is necessary is the Causes section. Delirium is a sensitive marker of illness, so it's very non-specific, i.e. probably anything can cause delirium. I think the section needs a discussion on how predisposing factors interact with precipitating factors, perhaps reviewing just the most common processes, e.g. drugs, hypoxia, infection. Thank you again for your guidance throughout. Dhj davis (talk) 10:41, 12 December 2012 (UTC)
 * Some further additions on clinical pathophysiology studies, summarising information from 3 systematic reviews. Where additional studies have been referred to since the publication of the SRs, these were (systematically) identified by re-running the searches detailed in the original SRs.Dhj davis (talk) 00:06, 1 February 2013 (UTC)

Experienced editors interested in supporting new editors
Per the proposed revision above, new editors are welcome to contact any editor listed below on their talk page for specific questions about how to edit Wikipedia. Also, the "Teahouse" is designed to be a welcoming place, and the links at MedWelcome-reg are useful because they contain good links and ways to contact other editors for help.

Comments

 * Can't we name "Adverse outcomes after delirium" just "Prognosis" per WP:MEDMOS?
 * yep. done Casliber (talk · contribs) 06:43, 21 November 2012 (UTC)

 * If it is causative, let's specify a mechanism. If it's just a consistently observed association, let's just state that it is associated?
 * not so easy. can be very difficult in hospital inpatients with complex medical problems to deifinitly assign causes. Casliber (talk · contribs) 06:43, 21 November 2012 (UTC)
 * These are consistently observed associations from prospective studies. These can't on their own make causative claims. Dhj davis (talk) 12:07, 23 November 2012 (UTC)

 * "It" is "long-term poor outcomes", which is too vague.
 * "Only studies that looked at the independent effect of delirium were included". How can we be certain that methodologically they corrected for all confounding variables? That overstates the source, most likely.
 * This was a rigorously conducted systematic review and an inclusion criterion was that all associations were adjusted for age, sex, etc, but *also* that predisposing factors (e.g. baseline frailty, dementia) and precipitating factors (e.g. illness severity, physiological and metabolic parameters) were adjusted for. Of course, this is a meta-analysis of observational data, so there is always a risk of residual confounding, but it's the best estimate we have. Dhj davis (talk) 12:07, 23 November 2012 (UTC)

 * We shouldn't be describing studies this much "(i.e., after accounting for other associations with poor outcomes, for example co-morbidity or illness severity)." Encyclopedias just state the facts. Studies have limitations. So then we just state the facts as best we can given those limitations.
 * Thanks, that was what I was trying to do - show that the systematic review had considered these limitations and accounted for them. (see below about my WP:MEDRS question). Dhj davis (talk) 12:07, 23 November 2012 (UTC)

 * "A systematic review collected all studies that followed-up this population for at least three months after discharge from hospital." Irrelevant. Of course we should be using WP:MEDRS. Let's just state the facts.
 * For my clarification, is the spirit of WP:MEDRS that because this is a systematic review in JAMA (i.e. reliable), it's not necessary to add detail qualifying the nature of the study (methods etc)? I'll take that out. On the other hand, any tips on how to balance this with overstating the source (as above)? Dhj davis (talk) 12:07, 23 November 2012 (UTC)
 * A late reply but no, it's not necessary to qualify the nature of the study. Biosthmors (talk) 20:27, 18 January 2013 (UTC)

 * "One study has investigated these same associations in the general population, and found consistent results". How can we be certain this isn't cherry-picked? This is why we use reviews and follow WP:MEDREV
 * Thanks for pointing this out - it does read like it's cherry picked, but in fact it's the *only* study of delirium outcomes in an unselected, general population. It's the study I'm an author on, but I wouldn't want you to think that compromises WP:NPOV. It's not a controversial finding, and strengthens the results of the systematic review in the population of hospital patients. The reason for it being mentioned it that it overcomes some of the biases that the systematic review is vulnerable to (because that only studies persons in hospital once delirium has developed, without the advantage of prospective, pre-delirium cognitive assessments (i.e. a 'before' and 'after' picture).Dhj davis (talk) 12:07, 23 November 2012 (UTC)

 * Those are my comments just for the first paragraph of that section. I can't say I like anything it says. I'm glad you're here to help out!
 * The rest of the section probably doesn't need any level three subheadings (such as ===Death=== ) which should probably just be mortality/mortality rate in prose, I imagine.
 * Costs should go under Society and culture per WP:MEDMOS. If enough data exists, an Economics section can stand alone. Biosthmors (talk) 06:14, 21 November 2012 (UTC)

Addition 6 Dec
The following sentence was added: It is not as important which tool is used as that the patient gets monitored. Without using one of these tools, 75% of ICU delirium is missed by the practicing team, which leaves the patient without any likely active interventions to help reduce the duration of his/her delirium.

This requires a source, particularly because a numerical claim is made, and gives the suggestion of passing judgement. JFW | T@lk  20:29, 6 December 2012 (UTC)
 * Thanks JFD. The primary study where the 75% figure comes from is this one:, but I've gone for a secondary source that also mentions it. Dhj davis (talk) 21:26, 6 December 2012 (UTC)
 * Fantastic. JFW | T@lk  23:21, 6 December 2012 (UTC)

Drugs versus Medication
In the section Delirium, there are separate sub-sections for "Medication" and "Drugs". Should these not be combined, particularly as medication is also referred to as a pharmaceutical drug? Also, the sub-section "Substance withdrawal" should be merged into "Drugs" (where it is already discussed). I don't want to do this myself as this is not my area of expertise. HairyWombat 23:15, 21 January 2013 (UTC)
 * Agree, and we will address this when the 'Causes' section is overhauled. Dhj davis (talk) 00:06, 1 February 2013 (UTC)
 * Just started the causes section, but called away before adding references etc. Will return to this shortly. Dhj davis (talk) 17:06, 8 February 2013 (UTC)
 * Admittedly more to do with the references, but I've run out of time for now....Dhj davis (talk) 20:31, 8 February 2013 (UTC)
 * Thanks for your edits! Biosthmors (talk) 20:51, 8 February 2013 (UTC)

 * The list looks good. Could I recommend that nested lists of causes are converted to tables? See WP:EMBED. You could grab the code from hypopituitarism or pneumothorax where I used this approach. JFW | T@lk  23:50, 9 February 2013 (UTC)

Good Article aspirations
Just to point out that Delirium is on this list: WikiProject Medicine/Good article goals for 2013, and that the European Delirium Association and the American Delirium Society will be helping with edits here over the next few months.Dhj davis (talk) 00:06, 1 February 2013 (UTC)

Emergency medicine
Delirium in the Emergency Department - 10.1136/emermed-2011-200586 JFW | T@lk  20:48, 21 March 2013 (UTC)

Delirium should be contrasted with dementia
Hence dementia is "chronic" loss of cognition, whereas delirium is "acute" loss of cognition. PS: Delirium and confusion are distinct (from a psychiatric perspective)-since confusion occurs to everyone, and delirium - does not. 129.180.175.45 (talk) 09:05, 25 October 2013 (UTC)

 * I've read through it more thoroughly, and it just is really badly written. For example, in the opening paragraph, essentially, it is NECESSARY to refer to the DSM diagnostic criteria. Not just what "somebody thinks" 129.180.175.45 (talk) 23:29, 25 October 2013 (UTC)

Merger proposal
Received request to merge the article into the  article on 14 November 2013. Discuss it here. GenQuest "Talk to Me" 02:21, 15 November 2013 (UTC)
 * Disagree, I believe these have different social and cultural connotations and shouldn't be merged. --LT910001 (talk) 03:02, 16 November 2013 (UTC)
 * Disagree Indeed they overlap but are different. A person with dementia, for example, may have permanent mental confusion, but is not delirious. And some set of delirious people are not actually confused (disoriented, etc) but simply have an inability to focus (like temporary ADD, or even ADHD). And of course some delirious people are simply drowsy, but again not confused. Anybody who hasn't slept in 48 hours or more will be clinically delirious. How confused they are, depends on the person. S  B Harris 03:01, 23 December 2013 (UTC)
 * Disagree for reasons stated. JFW | T@lk  14:52, 23 December 2013 (UTC)

Age as predictor
The article was changed by :

It is a syndrome which occurs more frequently in people in their later years although it is unclear whether it is in fact a function of age per se or whether it is simply a reflection of the fact that older people tend to develop critical illness more frequently.

I would like to see the source before this sentence can be allowed to stand. In daily practice it is exceedingly common for elderly people to develop delirium in the context of really very mild acute illness, while in younger people you need to be critically ill before that happens. For the moment I've taken out the entire sentence. JFW | T@lk  07:35, 19 January 2014 (UTC)
 * Thank you JFW and I agree with you! However, since there seems to be no controversy about "It is a syndrome which occurs more frequently in people in their later years" I put that sentence back in.  Lova Falk     talk   19:55, 19 January 2014 (UTC)

 * I don't mind having it put back, but seemed to be challenging it. JFW |  T@lk  20:18, 19 January 2014 (UTC)
 * I cannot see that challenges the higher prevalence, which is exactly what we say in this sentence.   Lova Falk     talk   20:34, 19 January 2014 (UTC)

 * The obvious conclusion which the original author intended to convey was that older people are more susceptible to ICU delirium. What I suggested is that it is "unclear" whether the more frequent occurrence in older people is a function of their being old or whether it is simply a function of their being present in ICUs more often. If there is in fact research which establishes that what I called "unclear" is in fact "clear" then I believe it is incumbent upon the reverter to cite a reference which reached that conclusion. I don't think there is any such research. On the other hand, the October 2 (or 3), 2013 edition of the New England Journal of Medicine includes a research paper which either explicitly or implicitly states that ICU delirium occurs at approximately the same rate in all age groups, genders, etc. Unfortunately, NEJM current maintains an embargo on this article. I will probably reinstate with general reference to the article. But before I do I want to give the reverter a chance to include the research he/she claims makes it "clear".QuintBy (talk) 22:16, 19 January 2014 (UTC)
 * QuintBy, when you add text you also need to add a source for your text - even when stating something is unclear. It is not up to the reverter to find a source that supports the revert, it is up to the author of the added text to find a source that supports the addition.  Lova Falk     talk   08:53, 20 January 2014 (UTC)

 * We need a secondary source for your claim, as outlined in WP:MEDRS. It bears remembering that delirium is exceedingly common in hospitalised (and even community-dwelling) people, predominantly the elderly. ICU cares for only a small proportion of those people. You might be right that on ICU everyone is so unwell as to carry a roughly equivalent risk of delirium, but this does not apply to other groups. JFW | T@lk  20:29, 20 January 2014 (UTC)

 * You will note that 'ICU delirium' redirects to "Delirium", meaning that the article is supposed to refer to BOTH conditions. I believe I was quite careful to note that what I was referring to is ICU delirium. It is indeed a shame that some misguided editor decided that everything to do with delirium should be contained in one article, but there it is. I can certainly see how someone who works only in a nursing home environment would come to believe that only older people develop delirium. There are, after all, no younger patients there with rare exception. — Preceding unsigned comment added by QuintBy (talk • contribs) 20:43, 22 January 2014 (UTC)

Sorry, I cannot let that go unchallenged. Your edit suggested that age was not a predictor of delirium risk, which is amply contradicted both by experience and by data. You noted the distinction only in your edit summary, which is not visible to readers who are simply perusing the article.

I don't think the decision to discuss all forms of delirium in a single article is "misguided", nor was it the decision of a single editor. Much of what we know about delirium in the frail elderly comes from studies in ICU delirium, and the pathophysiology is one and the same. The management strategies, too, are very similar (e.g. reorientation, low-stimulus nursing, pharmacotherapy). JFW | T@lk  21:39, 22 January 2014 (UTC)

 * What the most recent research in the area of ICU delirium has indicated is that "what we know about (ICU) delirium" is mainly wrong because it HAS been based upon observations by gerontologists who didn't have a clue that ICU delirium occurred in younger patients. QuintBy (talk) 05:43, 27 July 2014 (UTC)

EEG
10.1186/s13054-014-0674-y - EEG may help prognosticate. JFW | T@lk  20:37, 13 December 2014 (UTC)

Critical care delirium - systematic review
10.1186/s13054-015-0886-9 JFW | T@lk  12:12, 23 April 2015 (UTC)

Video
It seems that the video explanation, which is mostly text-based, is an unferenced and unpublished synthesis, which is both unhelpful (in the presence of the text), unreferenced (breaching WP), and promotional (advertising and self-aggrandizement at the end). Perhaps I'm being too harsh, as I'm sure that the original creator was trying to be helpful. Nevertheless, given the problems, delete? Klbrain (talk) 22:33, 13 February 2017 (UTC)
 * User:Doc James has removed the Template:Synthesis without attempting discussion here. The edit comment has "contains refs", but I can see no evidence to support this. There is a link to open.osmosis.org, but this is the web publisher and isn't a source for the content. So, I've reversed the edit until there is evidence of referencing or another argument made. Klbrain (talk) 14:03, 16 March 2017 (UTC)

Created by known medical experts. They are working to add references. Initially missed the discussion here. Thanks for pinging me. Doc James (talk · contribs · email) 04:03, 18 March 2017 (UTC)

 * Refs been added Doc James (talk · contribs · email) 15:08, 21 March 2017 (UTC)

JAMA
Review 10.1001/jama.2017.12067 JFW | T@lk  18:48, 26 September 2017 (UTC)

Work Plan for Proposed Changes - Mar 2019
Hello everyone, I am a senior medical student in UCSF's Wikiproject-Medicine effort who hopes to further improve this article for a very important topic.

<> On initial analysis, some aspects for improvement are: lead discussion can be more concise, numerous redundancies/tautologies throughout article, complicated language and complex terminology that surpasses postgraduate-level training per Hemingwayapp, article has not been substantially updated in 2 years, can possibly incorporate some of the reviews suggested in the Talk discussions <> Current strengths: very smartly structured, extensive discussion on pathophysiology+diagnosis, richly cited, the authors obviously care deeply about the topic <> My main goals this month is to enhance readability for a more general audience and to incorporate newer literature RE: delirium.

By the following days, I will… (bolded = check in’s with team)  Fri 3/8: Submitted a work plan, present any obstacles to group Mon 3/11: Get more familiar with the Wiki interface, post preliminary edits RE: readability, WP:MEDMOS Wed 3/13: Assess currently cited references per WP:MEDRS Fri 3/15: Gather further literature, Celebrate matching into residency (yay?) Mon 3/18: Incorporate said literature, Reorganize sections/headers if needed Wed 3/20: Peer review begins Mon 3/25: Peer reviews complete, Respond to suggestions Thu 3/28: Final Wrap Up

I will use the following questions to help guide me in this process: •	Is each fact referenced with an appropriate, reliable reference? •	Is everything in the article relevant to the article topic? Is there anything that distracted you? •	Is the article neutral? Where does the information come from? Are these neutral sources? •	Are there viewpoints that are overrepresented, or underrepresented? •	Check a few citations. Do the links work? Is there any close paraphrasing or plagiarism in the article? •	Is any information out of date? Is anything missing that could be added? •	What resources do you intend to look up, and when? •	How will you decide what things (signs, symptoms, side-effects, etc.) to explicitly include? To explicitly exclude? •	How will you ensure you avoid "doctor-speak" and not use jargon?

'''PLEASE: I would greatly appreciate any guidance during this journey. Thanks!''' — Preceding unsigned comment added by 199.241.201.84 (talk) 04:11, 8 March 2019 (UTC)

WikiMed Spring 2019 UCSF SOM Peer Review
Hello Wikipedians! I'm a fellow classmate of Alulu00, the medical student who has been editing this page recently. I am posting a peer review of his edits and some feedback on the article as a whole to help contribute to the development of this page. I focused on everything up to, and including, the pathophysiology section as requested by my peer.

Overall, I think you've done a fantastic job! I looked through the version of the article from before you started editing and you have contributed a lot. You have continued to use your work plan as a guide and I can see the influence of the questions you noted that you wanted to keep in mind. I've learned/refreshed a lot by reading through your article! You have Feel free to incorporate any or none of the feedback below!

 * I'm not sure if this would work with delirium, but it might be nice to have an image or two in the article. Possibly in the pathophysiology section under neuropathology or neuroimaging?  I'm really not sure though.

 * Parenthetical use: I use parentheses constantly, so this is something I tend to pay attention to more. There are various places where it could be beneficial to remove the parentheses and break the sentence up into two sentence. For example:
 * "Delirium is caused by an acute organic process (i.e. a physically identifiable structural, functional, or chemical problem in the brain), which may arise from a disease process outside the brain that nonetheless affects the brain."
 * vs
 * "Delirium is caused by an acute organic process, which is a physically identifiable structural, functional, or chemical problem in the brain. This may arise from a disease process outside the brain that, nonetheless, affects the brain."

 * Medical Language:
 * in the opening section, second paragraph, the word "mentation" is used, but for simplicity "mental function/status/etc..." might be clearer.

 * Opening section, second paragraph: "In contrast, fluctuations in mentation due to changes in primarily psychiatric processes or diseases (e.g. schizophrenia, bipolar disorder) are, by definition, not termed 'delirium.'"
 * "psychiatric" is italicized, but might not need to be
 * instead of "are, by definition, not termed 'delirium'", simply "are, by definition, not delirium" or "do not, by definition, meet the criteria for delirium"

 * Opening section, third paragraph: "sedative hypnotic" can probably be linked to its personal wikipedia page so people can look up what that means.

 * Opening section, fourth paragraph: I always struggle with consecutive citations from the same source. Should each of those sentences have the [1] citation after it, or should it just be after the last sentence that is from that source?

 * Signs and symptoms section: some of the symptoms listed don't have references. Is this list all from one source, or is it pieced together from various places?  If its from one source, you could add a single citation to the end of the statement "The various features of delirium are further described below:" to cover everything below.

 * Signs and symptoms section: definition for disorientation might be able to be streamlined slightly, possibly removing the first part and starting with "This describes..."

 * Signs and symptoms section: definition for sleep changes has some redundancy in the two sentences and might be able to be combined: "In delirium, sleep disturbances typically involves fragmented sleep or even sleep-wake cycle reversal (i.e. active at night, sleeping during the day) and often precedes the onset of an episode."

 * Signs and symptoms section, Persistent delirium subsection: the sentence "English medical writer Philip Barrow noted in 1583 that if delirium resolves, it may be followed by a 'loss of memory and reasoning power.'" doesn't have a citation, does it need one?

 * Signs and symptoms section, Dementia and ICU subsection: the sentence
 * "...leaving many ICU survivors disabled and unable to go back to work and unable to serve effectively as the matriarchs and patriarchs of their families." can probably be shortened to "...leaving many ICU survivors permanently disabled." The addition of serving as matriarchs and patriarchs feels more like commentary and might not be the same for all patients.
 * The following sentence feels a bit long and might benefit from being shortened: "The implications of such an “acquired dementia-like illness” (note: the term here is being used in a circumstance in which not all patients continue to decline as some have persistent yet stable brain dysfunction and others with newly acquired brain problems can recover fully) are profound at the private level, dismantling the person’s life in very practical ways, such as impairing ability to find a car in a parking lot, complete shopping lists, or perform job-related tasks done previously for years."

 * And/Or use: for simplicity of the article, there are a couple places where "and/or" is used that could probably just use "or" to convey the same message.

 * Pathophysiology opening statement: "In general" can probably be removed.

 * Pathophysiology section, CSF biomarker, Neuroimaging, Neurophysiology subsections: "A 20** systematic review..." readers might not know what a systematic review is, maybe "Research suggests that..." and then just cite the review to streamline it.

 * Pathophysiology section, Neuropathology subsection: Two case studies and a retrospective study are mentioned. I know we are aiming to avoid primary sources, but I'm guessing this field of research is sparse and maybe we don't have great secondary resourced.  Similar to the above comment, maybe just noting "Research shows" instead of mentioning the type of study for simplicity.

Sorry for all the notes. I tried to focus on sentence structure/grammar/etc (as you can tell) since I know you mentioned that cleaning up some of the language of the article would be a major focus. Again, you've done great work! I just got really into this article.

Thayermartin (talk) 05:44, 25 March 2019 (UTC)

>>>Thank you, Thaymartin, for your very helpful comments! I incorporated much of what you suggested, including some in reference to sections (Dementia in ICU survivors) that I didn't have the opportunity to go over yet. I kept the "and/or" in the Causes and some other sections because it was important for its meaning. alulu00 (talk) 13:44, 27 March 2019 (UTC)

ok where to from here....
Right then, the article looks different to the last time I popped in here.....so aiming for some sort of stable version (GA being a good place to start with) Cas Liber (talk · contribs) 19:47, 5 July 2019 (UTC)

 * On first impressions, the writing looks dense and needs to be less jargony without losing meaning.
 * lead seems a little repetitive and statements in the wrong order (i.e. having how long it is before describing what it is)
 * history of term can be expanded - see here. also relationship between layterm and medical term.

Queen's University Student Editing Initiative
Hello, We are a group of medical students from Queen's University. We are working to improve this article over the next month and will be posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit.

Thank you! 14kl3 (talk) 20:18, 11 November 2019 (UTC)

Queen's University Student Editing Initiative: Proposed Changes
Hello,

We are proposing the following changes to this page on behalf of the Queen's University Student Editing Initiative:

Current Sentence A (Delirium#Treatment#Non-Pharmacologic Interventions): “Of note, severe agitation that endangers self or others may require physical restraints and professional supervision, but only as a last resort.”

Proposed Updated Sentence A: Restraints should rarely be used as an intervention for delirium. The use of restraints has been recognized as a risk factor for injury and aggravating symptoms, especially in elderly inpatients. The only cases where restraints should sparingly be used during delirium is in the protection of life-sustaining interventions, such as endotracheal tubes.

Current Sentence B (Delirium#Pathophysiology#Neuroimaging): “Despite similar heterogeneity in study design as described in an older 2008 analysis, a 2017 systematic review summarizes evidence of associated white matter disease (including cerebral atrophy, ventricular enlargement, and white matter lesions), abnormal changes in diffusion MRI characteristics and brain metabolites (reflecting microscopic tissue damage and non-neuronal nervous cell activity), and abnormal connectivity between different functional regions of the brain (consistent with interruptions in executive function, sensory processing, attention, emotional regulation, memory, and orientation as seen in delirium).”

Proposed Updated Sentence B: Edits (structural + clarification): Evidence for changes in structural and functional markers include: changes in white-matter integrity (white matter lesions), decreases in brain volume (likely as a result of tissue atrophy), abnormal functional connectivity of brain regions responsible for normal processing of executive function, sensory processing, attention, emotional regulation, memory, and orientation, differences in autoregulation of the vascular vessels in the brain, reduction in cerebral blood flow and possible changes in brain metabolism (including cerebral tissue oxygenation and glucose hypometabolism). Altogether, these changes in MRI-based measurements invite further investigation of the mechanisms that may underlie delirium, as a potential avenue to improve clinical management of people suffering with this condition. Current Sentence C (Delirium#Pathophysiology#Neuroimaging): “Although neuroimaging offers a non-invasive way to understand delirium, it has been challenge to establish correlates with delirium.” Proposed Updated Sentence C: Edits (mainly structural + update of reference): Neuroimaging provides an important avenue to explore the mechanisms that are responsible for delirium. Despite progress in the development of magnetic resonance imaging (MRI), the large variety in imaging-based findings has limited our understanding of the changes in the brain that may be linked to delirium. Current Sentence D (Delirium#Pathophysiology#Neuroimaging): “Many attempts to image people with concurrent delirium are unsuccessful. In addition, there is a more general bias selecting younger and fitter participants amenable to scanning, especially if using intensive techniques such as MRI.” Updated Sentence D: Edits (structural + clarification + source): Some challenges associated with imaging people diagnosed with delirium include participant recruitment and inadequate consideration of important confounding factors such as history of dementia and/or depression, which are known to be associated with overlapping changes in the brain also observed on MRI. Current Sentence E (Delirium#Prevention): "Delirium may be prevented by systematically addressing the common contributing factors, such as constipation, dehydration, low oxygen levels, immobility, and the simultaneous use of multiple or problematic medications."

Updated Sentence E: Delirium may be prevented and treated by using non-pharmacologic approaches focused on risk factors, such as constipation, dehydration, low oxygen levels, immobility, visual or hearing impairment, sleep deprivation, functional decline and removing problematic medications. Current Sentence F (Delirium#Treatment#Non-Pharmacologic Interventions): "Such interventions are the first measures in managing active delirium and has many overlaps with delirium preventative strategies, including optimizing the hospital environment by reducing ambient noise, providing proper lighting for the time of day, minimizing room changes and restraint use."

Proposed Updated Sentence F: These interventions are the first steps in managing acute delirium and there are many overlaps with delirium preventative strategies. In addition to treating immediate life-threatening causes of delirium (e.g. low O2, low blood pressure, low glucose, dehydration), interventions include optimizing the hospital environment by reducing ambient noise, providing proper lighting, offering pain relief, promoting healthy sleep-wake cycles, and minimizing room changes. Although multicomponent care and comprehensive geriatric care are more specialized for a person experiencing delirium, several studies have been unable to find evidence showing they reduce the duration of delirium. Current Sentence G (Delirium#Treatment#Medications): "The treatment for delirium with medications depends on its cause. Low-dose haloperidol when used short term (one week or less) is the most studied and standard drug for delirium. Evidence for efficacy of atypical antipsychotics (i.e. risperidone, olanzapine, ziprasidone, and quetiapine) is emerging, with the benefit for fewer side effects. Antipsychotics however are not supported for the treatment or prevention of delirium among those who are in hospital. Benzodiazepines themselves can trigger or worsen delirium, and there is no reliable evidence for use in non-alcohol-related delirium. If the delirium involves alcohol withdrawal, benzodiazepine withdrawal, or contraindications to antipsychotics (e.g. in Parkinson's disease or neuroleptic malignant syndrome), then benzodiazepines are recommended. Similarly, people with dementia with Lewy bodies may have significant side effects to antipsychotics, and should either be treated with a none or small doses of benzodiazepines. The antidepressant trazodone is occasionally used in the treatment of delirium, but it carries a risk of over-sedation, and its use has not been well studied."

Proposed Updated Sentence G: Evidence for the effectiveness of medications (including antipsychotics and benzodiazepines) in treating delirium is inconclusive.Low-dose haloperidol when used short term (one week or less) is the most studied and standard drug for delirium. Evidence for efficacy of atypical antipsychotics (i.e. risperidone, olanzapine, ziprasidone, and quetiapine) is emerging, with the benefit for fewer side effects. Use antipsychotic drugs with caution or not at all for people with conditions such as Parkinson's disease or dementia with Lewy bodies. Benzodiazepines themselves can trigger or worsen delirium, and there is no reliable evidence for use in non-alcohol-related delirium. If the delirium involves alcohol withdrawal, benzodiazepine withdrawal, or contraindications to antipsychotics (e.g. in Parkinson's disease or neuroleptic malignant syndrome), then benzodiazepines are recommended. The antidepressant trazodone is occasionally used in the treatment of delirium, but it carries a risk of over-sedation, and its use has not been well studied. Current Sentence H (#Delirium#Diagnosis#Differential Diagnosis): "Other processes and syndromes that cause cognitive dysfunction resembling delirium include the following:"

Proposed Updated Sentence H: There are conditions that might have similar clinical presentations to those seen in delirium. These include dementia, depression, psychosis, and other conditions that affect cognitive function. + Remove “Long term learning disorders” from the list of differential diagnoses Proposed Change I (#Delirium#Diagnosis#Differential Diagnosis): Change the order of differential diagnoses from "Psychosis…,Dementia…, Depression…, Long term learning disorders…, Other mental illnesses…" to Dementia…, Depression…, Other mental illnesses…, Psychosis…

We look forward to your input.

14kl3 (talk) 19:58, 18 November 2019 (UTC)
 * Thank you for sharing your proposed article improvements. Do you mind including the page #s that you found the info for your text book reference? When editing the actual Wikipedia article you can re-use the same reference in the same Wikipedia article. When adding the reference using the visual editor while editing a wikipedia article, you can see the option to "reuse". Great work so far! JenOttawa (talk) 23:10, 18 November 2019 (UTC)

Consciousness
Hi everyone. I noticed the sentence "disturbances in consciousness" or something similar was removed and no longer written on the main page of Delirium. I have a feeling this is wrong, as Delirium does actually have some effect on consciousness. Would you say its okay to add that back, or, atleast explain, why was it removed? Since Delirium has many effects and symptoms, this is a prominent one, and I have personal experience with Deliriants I have used in my life with some medications, which cause Delirium. Noam111g (talk) 09:30, 3 November 2023 (UTC)

 * Okay. I have edited it to add the consciousness part. If anyone has a problem with that please let me know. Good Night. Noam111g (talk) 23:49, 3 November 2023 (UTC)

Wiki Education assignment: Global Poverty and Practice
— Assignment last updated by Aksgpp3131 (talk) 07:16, 19 December 2023 (UTC)

title: Talk:Delirium