Memory Impairment in Those Who Attempted Suicide by Benzodiazepine Overdose

Verwey, Bastiaan; Eling, P.A.T.M.; Wientjes, H.J.F.M.; Zitman, Frans G.

doi:10.4088/jcp.v61n0612

Cited by 30 publications

(18 citation statements)

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“…Both reported anterograde amnesia after benzodiazepine overdose in ward patients, which improved from day 1 to day 2 after overdose. 21,22 Given the evidence of acute effects of single doses of a variety of CNS-Ds, the sedative effects of overdose would obviously lead to profound impairments in the number of cognitive and psychomotor domains in the acute stage. Although such deficits are unlikely to be pertinent to the functionality of an inpatient who is under scrutiny of medical staff, even a subclinical cognitive impairment could be consequential if the effects persist at the time of discharge, when the individual is otherwise deemed fit enough to return to the community.…”

mentioning

confidence: 99%

Cognitive Impairment in Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose

Dassanayake

Michie²,

Jones³

et al. 2012

Journal of Clinical Psychopharmacology

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Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), working memory (Letter-Number Sequencing), and impulsivity and decision making (Cambridge Neuropsychological Test Automated Battery Information Sampling) in 107 patients with CNS-D overdose (benzodiazepines, opioids, or antipsychotics) with a control group of 68 with non-CNS-D overdose (acetaminophen, selective serotonin reuptake inhibitors, and serotonin noradrenaline reuptake inhibitors) on discharge from hospital. Outcome measures were adjusted for demographic and clinical covariates in multivariate regression models. Compared with the controls, patients in the CNS-D group were significantly impaired in all domains: they had prolonged Trail-Making completion times and reaction times, poorer working memory and planning and were more impulsive in decision making. Their Stockings of Cambridge Task performance was comparable to that of the control group for simple problems but worsened with increasing task complexity. The results show that patients with CNS-D overdose could be impaired in multiple cognitive domains underlying everyday functioning even at the time they are deemed medically fit to be discharged. Such impairments could adversely affect social and professional lives of this relatively young population during the immediate postdischarge period.

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confidence: 99%

Cognitive Impairment in Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose

Dassanayake

Michie²,

Jones³

et al. 2012

Journal of Clinical Psychopharmacology

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“…Previous studies have demonstrated lower immediate and delayed recall in patients or healthy volunteers who had ingested benzodiazepines (Verwey et al, 2000(Verwey et al, , 2005. These data suggest that after 12 hours, and even after 24 hours, patients remember little (Verwey et al, 2000). Should patients be seen shortly after arrival (a few hours after ingestion) or the next day (less than 12 hours after ingestion)?…”

Section: Efficiency Research Improvedmentioning

confidence: 84%

Strengthening evaluation through interactive problem structuring: A case study of hospital care after attempted suicide

et al. 2011

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Thequalityofanevaluationlargelydependsonthequalityoftheunderlyingproblemdefinition andthequalityoftheproblemdefinitionoftenimprovesasstakeholderinvolvementincreases. Bymeansofastudyonthemanagementofattemptedsuicidesbydrugoverdose,weexplored whetheraninteractivemethodologycouldbeadequateforproblemstructuring.Despitethefact thatahighlevelofcareisoftenunnecessary,manypatientsareadmittedtotheinternalward orintensivecareunit.Tosolvetheefficiencyproblem,somephysiciansproposedtoevaluatethe effectivenessofasix-hourobservationunit.Althoughevaluatingsuchaunitwastechnicallyfeasible, wefeltuncertainabouttheappropriatenessofthisintervention.Theinteractivemethodologywas usefulinthatiteffectivelymadethedivergentproblemdefinitionsandunderlyingnormativevalues transparent.As a result, our research efforts will be better geared to information needs from personsinvolvedandthereforemoreuseful.

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“…Furthermore, observer reports would mean little, because in many respects, a person in a blackout can appear normal. Because a blackout state may not be evident to the external observer (17,42,43), first-response criminal investigators may collect few observations about a defendant's state of intoxication even when the offender is arrested soon after the offense. At the same time, the detainee may lack insight regarding degree of cognitive impairment when in a state of intoxication, although he or she may later recognize a memory gap (17,44).…”

Section: Discussionmentioning

confidence: 99%

Claims of Amnesia for Criminal Offenses: Psychopathology, Substance Abuse, and Malingering

Stout

Farooque

2008

Journal of Forensic Sciences

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The forensic psychiatric examiner often encounters defendants who deny memory for their offense. Past research proposes a variety of factors to account for offense amnesia. To date there have been few systematic studies of offense amnesia in relation to psychiatric diagnosis, either alone or in combination with other known factors such as substance use and malingering. We studied 53 pretrial felony defendants who had been referred for psychiatric examination; 40% claimed amnesia for their offense. Examinees with psychotic disorders in general, and schizophrenia in particular, were relatively less likely to claim amnesia than were examinees with other diagnoses. Substance use at the time of the offense and associated substance use disorder diagnoses were positively associated with offense amnesia. Malingering diagnosed by general clinical criteria was a poor predictor of amnesia claims. These data suggests that two prominent reasons for referral for forensic psychiatric evaluation include the presence of psychotic symptoms and claims of amnesia for the offense.

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Memory Impairment in Those Who Attempted Suicide by Benzodiazepine Overdose

Cited by 30 publications

References 0 publications

Cognitive Impairment in Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose

Cognitive Impairment in Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose

Strengthening evaluation through interactive problem structuring: A case study of hospital care after attempted suicide

Claims of Amnesia for Criminal Offenses: Psychopathology, Substance Abuse, and Malingering

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