Delirium

Abstract

Delirium is a common neuropsychiatric syndrome. However, it is often misdiagnosed and management can be inconsistent and distressing for patients and their families. It has a diverse multifactorial aetiology and results in cerebral dysfunction. The criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, and the International Classification of Diseases, 11th revision, are increasingly unified in describing the core symptoms and profile. The new profiles are characterized by an acute disturbance of attention with a fluctuating pattern and impaired cognition. These profiles then incorporate non-cognitive symptoms, including disordered thinking and hallucinations. Non-pharmacological interventions prioritize staff training, early intervention including physiotherapy, a review of medications and environmental adaptations. Potential pharmacological approaches include the careful use of sedation and low-dose antipsychotics.