Delirium

Delirium is a neuropsychiatric syndrome that is characterised by a disturbance in attention, awareness, and cognition. It is a condition that can be temporary but severe, often resulting from an identifiable physiological cause. A psychological analysis of delirium would include the following criteria:

1. Disturbed Attention and Awareness: The primary feature of delirium is a significant difficulty in sustaining or shifting attention. The person’s awareness of the environment is also reduced, which might manifest as disorientation to time and place.
2. Develops over a Short Time and Fluctuates: Delirium tends to have an acute onset, developing over hours to a few days. Its symptoms tend to fluctuate in severity throughout the day.
3. Additional Cognitive Disturbances: In addition to attentional deficits, there are other cognitive disturbances. These might include memory deficit, disorientation, language, visuospatial ability, or perception disorders. Perceptual disturbances can include hallucinations, often visual, or illusions.
4. Evidence from the History, Physical Examination, or Laboratory Findings: This indicates that the disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal, exposure to toxins, or is due to multiple aetiologies.
5. Not Better Explained by Another Neurocognitive Disorder: Delirium is not better explained by another pre-existing, established, or evolving neurocognitive disorder and does not occur in the context of a severely reduced level of arousal such as coma.
6. Impact on Daily Living: The disturbance in cognitive functions significantly interferes with the individual’s ability to attend to basic personal needs or activities of daily living.

It’s important to note that delirium can be caused by a wide range of factors including infections, medications, surgery, intoxication or withdrawal from alcohol or drugs, and severe medical illnesses. It’s more common in older adults, particularly those with pre-existing brain disease, though it can occur at any age.

Treatment typically involves addressing the underlying cause, ensuring patient safety, managing behavioural and psychological symptoms, and providing supportive care. Early recognition and treatment are crucial, as delirium can lead to significant morbidity or even mortality.