Understanding Delirium

Delirium can be defined as an acute and sudden decline in focus of attention, as well as perception, and cognition.  On itself, delirium is not a disease, rather a clinical syndrome (or a set of symptoms), resulting from an underlying disease.  It is not synonymous with drowsiness and may occur without it. 

This is also not the same as dementia, although it commonly occurs among demented patients.  And, contrary to popular belief, people who are delirious do not have hallucinations or delusions.

The syndrome is associated with a disturbance of consciousness, such as reduced clarity of awareness of the environment. 

There are actually two varieties of dementia: 

(1) hyperactive behavior manifested by agitation or combativeness
(2) hypoactive variety manifested by the inability to converse or focus attention. 

Causes of delirium

Delirium can be caused by a structural defect or metabolic problem in the brain, as well as some psychiatric causes, which may also include mental or emotional stress, mental disease, or other programming problems. 

The syndrome can also be a result of severe physical illness or any process which interferes with the normal metabolism or function of the brain.  There is also an interaction between acute and chronic symptoms of brain dysfunction.

How delirium is diagnosed?

With careful assessment, delirium can easily be mistaken with a number of psychiatric disorders.  Delirium may be distinguished from psychosis, as the latter may not have impaired consciousness and cognition. 

The syndrome is also distinguished from dementia, as the latter is acquired and usually irreversible in nature.  It is also different from depression, as delirium is simply a case of lack of attention resulting from long-term learning disorders and varieties of congenital brain dysfunction.

How to treat delirium?

Treatment of delirium is achieved by determining the underlying cause (or causes) of this syndrome and treating it appropriately. 

Distressing symptoms of delirium are sometimes treated with antipsychotic drugs, especially those with minimal anticholinergic activity like haloperidol or risperidone. 

Non-medicating measures may also be effective in decreasing the incidence of delirium.


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