ABC of psychological medicine: Delirium

doi:10.1136/bmj.325.7365.644

BMJ 2002;325:644-647 ( 21 September )

Clinical review

ABC of psychological medicine

Delirium

T M Brown, M F Boyle.

The first 150 words of the full text of this article appear below.

Delirium is a common cause of disturbed behaviour in medically ill people and is often undetected and poorly managed. It isa condition at the interface of medicine and psychiatry that isall too often owned by neither. Although various terms have beenused to describe it $---$ including acute confusional state, acute brainsyndrome, and acute organic reaction $---$ delirium is the term usedin the current psychiatric diagnostic classifications and theone we will use here.

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Clinical features

Delirium usually develops over hours to days. Typically, the symptoms fluctuate and are worse at night. The fluctuation canbe a diagnostic trap, with nurses or relatives reporting thatpatients had disturbed behaviour at night whereas doctors findpatients lucid the nextday.

Impaired cognitive functioning is central and affects memory, orientation, attention, and planning skills. Impaired consciousness,with a marked variability in alertness and in awareness of theenvironment is invariably present. A . . . [Full text of this article]

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