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Impairment of mental alertness

MedGen UID:
737460
•Concept ID:
C1621860
•
Finding
Synonyms: Impaired alertness; Obtundation
SNOMED CT: Impaired alertness (704426000); Impairment of mental alertness (704426000)

Definition

A mental state of reduced level of consciousness, with decreased response to stimuli, including pain. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVImpairment of mental alertness

Professional guidelines

PubMed

Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.
Czeisler CA, Wickwire EM, Barger LK, Dement WC, Gamble K, Hartenbaum N, Ohayon MM, Pelayo R, Phillips B, Strohl K, Tefft B, Rajaratnam SMW, Malhotra R, Whiton K, Hirshkowitz M
Sleep Health 2016 Jun;2(2):94-99. Epub 2016 May 10 doi: 10.1016/j.sleh.2016.04.003. PMID: 28923267
Use of antiepileptic drugs in the treatment of epilepsy in people with intellectual disability.
Alvarez N, Besag F, Iivanainen M
J Intellect Disabil Res 1998 Dec;42 Suppl 1:1-15. PMID: 10030426
The diagnosis and management of diabetes insipidus during medical emergencies.
Buonocore CM, Robinson AG
Endocrinol Metab Clin North Am 1993 Jun;22(2):411-23. PMID: 8325295

Recent clinical studies

Etiology

Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review.
Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP
Horm Res Paediatr 2023;96(1):66-73. Epub 2022 Feb 10 doi: 10.1159/000522540. PMID: 35144259
A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration.
Lewis C, Walterfang M, Velakoulis D, Vogel AP
Dement Geriatr Cogn Disord 2018;46(5-6):285-297. Epub 2018 Nov 13 doi: 10.1159/000494210. PMID: 30423586
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Alcohol Consumption and Impairment of Surgeons: A Case for Total Abstinence?
O'Connor M
J Law Med 2017;24(3):556-64. PMID: 30137749
Effects of caffeine on human behavior.
Smith A
Food Chem Toxicol 2002 Sep;40(9):1243-55. doi: 10.1016/s0278-6915(02)00096-0. PMID: 12204388

Diagnosis

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed.
Ponsford J, Velikonja D, Janzen S, Harnett A, McIntyre A, Wiseman-Hakes C, Togher L, Teasell R, Kua A, Patsakos E, Welch-West P, Bayley MT
J Head Trauma Rehabil 2023 Jan-Feb 01;38(1):38-51. doi: 10.1097/HTR.0000000000000839. PMID: 36594858
A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration.
Lewis C, Walterfang M, Velakoulis D, Vogel AP
Dement Geriatr Cogn Disord 2018;46(5-6):285-297. Epub 2018 Nov 13 doi: 10.1159/000494210. PMID: 30423586
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Laboratory assessments in the course of Parkinson's disease: a clinician's perspective.
Müller T, Baas H, Kassubek J, Riederer P, Urban PP, Schrader C, Reichmann H, Woitalla D, Gerlach M
J Neural Transm (Vienna) 2016 Jan;123(1):65-71. Epub 2015 Nov 14 doi: 10.1007/s00702-015-1481-6. PMID: 26573521
Effects of caffeine on human behavior.
Smith A
Food Chem Toxicol 2002 Sep;40(9):1243-55. doi: 10.1016/s0278-6915(02)00096-0. PMID: 12204388

Therapy

The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers.
Ganesan S, Magee M, Stone JE, Mulhall MD, Collins A, Howard ME, Lockley SW, Rajaratnam SMW, Sletten TL
Sci Rep 2019 Mar 15;9(1):4635. doi: 10.1038/s41598-019-40914-x. PMID: 30874565Free PMC Article
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Sletten TL, Magee M, Murray JM, Gordon CJ, Lovato N, Kennaway DJ, Gwini SM, Bartlett DJ, Lockley SW, Lack LC, Grunstein RR, Rajaratnam SMW; Delayed Sleep on Melatonin (DelSoM) Study Group
PLoS Med 2018 Jun;15(6):e1002587. Epub 2018 Jun 18 doi: 10.1371/journal.pmed.1002587. PMID: 29912983Free PMC Article
Alcohol Consumption and Impairment of Surgeons: A Case for Total Abstinence?
O'Connor M
J Law Med 2017;24(3):556-64. PMID: 30137749
Wake-promoting pharmacotherapy for psychiatric disorders.
Dell'Osso B, Dobrea C, Cremaschi L, Arici C, Altamura AC
Curr Psychiatry Rep 2014 Dec;16(12):524. doi: 10.1007/s11920-014-0524-2. PMID: 25312027
Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang.
Moss M, Hewitt S, Moss L, Wesnes K
Int J Neurosci 2008 Jan;118(1):59-77. doi: 10.1080/00207450601042094. PMID: 18041606

Prognosis

Case 317.
Suthar PP, Jhaveri M, Mafraji M
Radiology 2023 May;307(3):e220788. doi: 10.1148/radiol.220788. PMID: 37093748
Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders.
Veenstra MS, van Dijk SDM, Bouman R, van Alphen SPJB, van Asselt ADIT, van den Brink RHS, Voshaar RCO
BMC Psychiatry 2022 Mar 24;22(1):214. doi: 10.1186/s12888-022-03857-8. PMID: 35331179Free PMC Article
Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions.
Brenner P, Piehl F
Acta Neurol Scand 2016 Sep;134 Suppl 200:47-54. doi: 10.1111/ane.12648. PMID: 27580906
Laboratory assessments in the course of Parkinson's disease: a clinician's perspective.
Müller T, Baas H, Kassubek J, Riederer P, Urban PP, Schrader C, Reichmann H, Woitalla D, Gerlach M
J Neural Transm (Vienna) 2016 Jan;123(1):65-71. Epub 2015 Nov 14 doi: 10.1007/s00702-015-1481-6. PMID: 26573521
Quality of life and its assessment in multiple sclerosis: integrating physical and psychological components of wellbeing.
Mitchell AJ, Benito-León J, González JM, Rivera-Navarro J
Lancet Neurol 2005 Sep;4(9):556-66. doi: 10.1016/S1474-4422(05)70166-6. PMID: 16109362

Clinical prediction guides

Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review.
Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP
Horm Res Paediatr 2023;96(1):66-73. Epub 2022 Feb 10 doi: 10.1159/000522540. PMID: 35144259
Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders.
Veenstra MS, van Dijk SDM, Bouman R, van Alphen SPJB, van Asselt ADIT, van den Brink RHS, Voshaar RCO
BMC Psychiatry 2022 Mar 24;22(1):214. doi: 10.1186/s12888-022-03857-8. PMID: 35331179Free PMC Article
Sleep, alertness and performance across a first and a second night shift in mining haul truck drivers.
Ganesan S, Manousakis JE, Mulhall MD, Sletten TL, Tucker A, Howard ME, Anderson C, Rajaratnam SMW
Chronobiol Int 2022 Jun;39(6):769-780. Epub 2022 Feb 17 doi: 10.1080/07420528.2022.2034838. PMID: 35176952
The Relationship Between Childhood Adversity and Other Aspects of Clinical Complexity in Psychiatric Outpatients.
Maunder RG, Wiesenfeld L, Lawson A, Hunter JJ
J Interpers Violence 2021 Oct;36(19-20):9060-9076. Epub 2019 Jul 24 doi: 10.1177/0886260519865968. PMID: 31339443
Fibrofog and fibromyalgia: a narrative review and implications for clinical practice.
Kravitz HM, Katz RS
Rheumatol Int 2015 Jul;35(7):1115-25. Epub 2015 Jan 13 doi: 10.1007/s00296-014-3208-7. PMID: 25583051

Recent systematic reviews

How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms.
Proost M, Habay J, De Wachter J, De Pauw K, Rattray B, Meeusen R, Roelands B, Van Cutsem J
Sports Med 2022 Sep;52(9):2129-2158. Epub 2022 May 11 doi: 10.1007/s40279-022-01678-z. PMID: 35543922
History for some or lesson for all? A systematic review and meta-analysis on the immediate and long-term mental health impact of the 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak.
Chau SWH, Wong OWH, Ramakrishnan R, Chan SSM, Wong EKY, Li PYT, Raymont V, Elliot K, Rathod S, Delanerolle G, Phiri P
BMC Public Health 2021 Apr 7;21(1):670. doi: 10.1186/s12889-021-10701-3. PMID: 33827499Free PMC Article
The neuropsychiatric effects of vitamin C deficiency: a systematic review.
Plevin D, Galletly C
BMC Psychiatry 2020 Jun 18;20(1):315. doi: 10.1186/s12888-020-02730-w. PMID: 32552785Free PMC Article
Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.
Czeisler CA, Wickwire EM, Barger LK, Dement WC, Gamble K, Hartenbaum N, Ohayon MM, Pelayo R, Phillips B, Strohl K, Tefft B, Rajaratnam SMW, Malhotra R, Whiton K, Hirshkowitz M
Sleep Health 2016 Jun;2(2):94-99. Epub 2016 May 10 doi: 10.1016/j.sleh.2016.04.003. PMID: 28923267
How reliable is the classification of cognitive impairment across different criteria in early and late stages of multiple sclerosis?
Fischer M, Kunkel A, Bublak P, Faiss JH, Hoffmann F, Sailer M, Schwab M, Zettl UK, Köhler W
J Neurol Sci 2014 Aug 15;343(1-2):91-9. Epub 2014 May 27 doi: 10.1016/j.jns.2014.05.042. PMID: 24950898

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