What is Delirium?

Delirium is:

1. A neurologic emergency

2. Characterized by an acute change in attention and cognition

• • Develops over a short period of time
  • Fluctuates over the course of the day

3. Is an interplay between predisposing risk factors and precipitating factors

4. Has 3 main motoric subtypes

• • Hypoactive
  • Hyperactive
  • Mixed

Let's elaborate:

DSM-V. Arlington, VA: American Psychiatric Association; 2013

• Delirium is characterized by disturbances in:
  • Attention
  • Awareness (reduced orientation to the environment)
  • Cognition (memory deficit, disorientation, language disturbance, perceptual disturbance)
• Develops over a short period, is a change from baseline, and tends to fluctuate during the course of the day
• Not explained by pre-existing, established, or evolving neurocognitive disorder
• Evidence from HPI, PE, or lab tests that disturbance is a physiologic consequence of medical condition, intoxicating substance, and/or medication use

References

DSM-V. Arlington, VA: American Psychiatric Association; 2013
Han JH, et al. Acad Emerg Med. 2009;16(3):193–200

Abbreviations

ED, emergency department

HPI, history of present illness

PE, pulmonary embolism