Psychiatry - H.T. Sonnyk 2003

General psychopathology and symptomatology of mental illnesses
Syndromes dominated by impairment of consciousness

There is no strict clinical Definition of the term "clouding of consciousness." Nevertheless, all syndromes involving a clouded state of consciousness share common features. K. Jaspers (1965) was the first to outline them: 1) the patient's detachment from the environment, characterized by blurred, impaired, and fragmented perception; 2) Various Forms of disorientation regarding time, place, surroundings, situation, and personal identity; 3) disorganized thinking accompanied by impaired or impossible judgment and speech disturbances; 4) amnesia for the period of clouded consciousness.

Non-Psychotic syndromes of clouded consciousness.

Nubilation (obnubilation) — a mild form of clouding, often described as a "veil over the mind" or mental haze. Patients' reactions, particularly speech, slow down. Confusion, inattentiveness, and errors in responses emerge. A sense of carefree indifference is frequently observed.

Somnolence — a semi-comatose or drowsy state where the patient lies with their eyes closed for the majority of the time. Spontaneous speech is absent, yet simple questions are answered correctly. More complex questions are not comprehended. External stimuli can temporarily alleviate the symptoms of both obnubilation and somnolence.

Stupor (obtundation) — patients are apathetic, indifferent to their surroundings, perceive questions only after a delay, and are capable of grasping only the simplest ones. Thinking is slowed and impaired. Vocabulary is limited. Responses are monosyllabic, with perseveration frequently occurring.

Sopor (deep stupor) — a state of pathological Sleep. The patient lies motionless with closed eyes and an expressionless (amimic) face. Verbal communication is impossible. Strong stimuli (bright light, loud sounds, pain) provoke undifferentiated, stereotyped defensive motor reactions and, occasionally, vocal responses.

Coma — a complete loss of consciousness accompanied by a lack of response to any stimuli and The Emergence of pathological Reflexes.



Last update: 11/08/2026

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