Delerium - Mental Health

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Delirium is a medical term used to describe an acute and relatively sudden decline in attention-focus, perception, and cognition. Because it represents a change in cognitive function, the diagnosis cannot be made without knowledge of the affected person's baseline level of cognitive function. Episodes of Delirium may include illusions, hallucinations or extreme excitement.

It is common for delirium to be easily confused with a number of psychiatric disorders because many of the signs and symptoms are conditions present. Such conditions include dementia, depression, and psychosis.

Delirium is a common acute disorder affecting adults in general hospitals. US figures indicate that Delirium affects 10-20% of all hospitalised adults, and 30-40% of elderly hospitalised patients.

Delirium is not a disease. Rather it is a clinical syndrome which result from an underlying disease or problem. Commonly Delirium is used to refer to drowsiness and disorientation; more broadly however, a number of other symptoms (including sudden inability of focus attention, sleeplessness and severe agitation and irritability) are also defined as "delirium."

Delirium may be caused by severe physical, mental illness or any process which interferes with the normal metabolism or function of the brain. For example, fever, pain, poisons, brain injury, surgery, traumatic shock, severe lack of food or water or sleep are all known to cause delirium. Commonly withdrawal symptoms of certain drug and alcohol dependent states are known to make a patient delerious.

In addition, there is an interaction between acute and chronic symptoms of brain dysfuction; delirious states are more easily produced in people already suffering with underlying chronic brain dysfunction.

The most important step in managing Delirium is early recognition because if Delirium is not diagnosed, it is doubtful that attempts will be made to reverse it. Once Delirium is detected, efforts should focus on identifying the etiology which is often done by assessing the sufferer for the presence of known risk factors.

Both prevention and treatment will typically focus on the minimisation and or elimination of predisposing and precipitating factors such as excessive use of certain drugs. The theoretical goals of management are to improve the patient’s cognitive status and reduce the risk of adverse outcomes such as aspiration, prolonged immobility, increased length of acute care, institutionalisation, and in severe cases death.

Often the first step in treatment for Delirium is to assess the patient’s current medications for any offending agents that may be causing or exacerbating the episodes of Delirium.

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