Delirium
Description
- Acute, fluctuating disturbance of attention and awareness with disorganised thinking, caused by a medical condition, drug or withdrawal
- *A medical emergency and a symptom, not a diagnosis* - the question is always "delirium due to what?"
Subtypes
| % | Features | Problem | |
|---|---|---|---|
| Hypoactive | ~50% | Withdrawn, drowsy, slow, quiet | *Most missed; worst prognosis*; mistaken for depression or "just tired" |
| Hyperactive | ~25% | Agitated, restless, hallucinating, wandering | Recognised because it is disruptive |
| Mixed | ~25% | Alternates |
Core features
- Inattention - the cardinal feature; cannot sustain, focus or shift attention
- Acute onset (hours-days) and fluctuation - worse in the evening (sundowning), lucid intervals
- Altered conscious level, disorganised thinking, disorientation
- Perceptual disturbance - visual hallucinations, illusions, persecutory delusions
- Sleep-wake cycle reversal
- Emotional lability, autonomic arousal
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