What is a Delirium?

What is a delirium? A delirium is also known as an acute confusional state and can arise due to a number of different conditions, both medical and psychological. Delirium is described as a severe neuropsychiatric syndrome, but it is a set of symptoms rather than a disease and is basically the manifestation of a mental or brain dysfunction.

What causes a state of delirium?

A state of delirium can be caused by any number of different things, but the main causes are critical illness, substance withdrawal, brain traumas and neurological disorders.

Diseases such as pneumonia or systemic infections or diseases of the central nervous system can lead to the symptoms of delirium if left untreated. Certain metabolic disorders such as hypoxia or hypoglycaemia can cause the symptoms of delirium.

Delirium can also be a side effect of withdrawal from certain drugs, including opioids and benzodiazapenes. Alcohol withdrawal can also cause the symptoms of delirium.

Serious head trauma can lead to the symptoms of delirium, but delirium can also be caused by damage to the brain as a result of a stroke, brain tumour or embolism.

Delirium is sometimes seen in the later stages of Alzheimer’s disease and dementia patients and is an indication of serious cognitive decline.

What is a delirium and what are the symptoms of delirium?

The definition of delirium covers several different types of delirium, ranging from medical delirium arising from a physical illness, and psychological delirium as a result of a mental illness, but the main features of delirium are:

• Impaired cognition—disturbances to memory, perception or problem solving skills
• Disturbed consciousness and reduced ability to focus on anything
• The onset of delirium may be as short as a matter of hours or as long as several days; onset can often vary.
• Sleep disturbances are common
• Patients can exhibit overactive or underactive behavioural patterns
• Thinking is impaired and appears to be slow, but thought patterns remain complex in nature.
• Hallucinations may also be evident.

How is delirium diagnosed?

Delirium can be distinguished from psychosis, although there is a degree of overlap and some disorders, specifically manic episodes of bipolar, can cause delirium-like symptoms.

A diagnosis of delirium requires careful assessment in order to identify the underlying cause of the symptoms in the patient. Because delirium is classed as an “acute” confusional state, the symptoms must have a recent onset. The patient’s baseline condition must also be known in order for a comparison with their normal mental ability to be made along with a correct diagnosis. It is also important to distinguish delirium from confusion as the two states are not the same—a delirious person is not necessarily confused and vice versa.

What is the treatment for a delirium?

Once the correct diagnosis has been made, treatment will be targeted at the underlying medical condition responsible for the state of delirium in the patient. In most cases the symptoms of delirium are reversible, although if left untreated, delirium can sometimes lead to death.