Delirium: = Acute Confusional Disorder = Encephalopathy= Acute Medical Emergency. Delirium often is unrecognized or misdiagnosed and commonly is mistaken for dementia, depression, mania, an acute schizophrenic reaction, or part of old age (patients who are elderly are expected to become confused in the hospital). Kannayiram.A $ Patrica B Delirium is a medical emergency syndrome. Delirium is common in medical in-patients and has serious adverse effects on mortality, functional outcomes, LOS and institutionalization. R: University of Leeds 2006 Delirium is the result of an organic insult to the brain that hinders its appropriate functioning. In spite of its organic basis, the diagnosis of delirium is totally based on the clinical presentation of the patient, which can be subtle دقيق، ماكر، خبيثand difficult to identify. 5 Delirium is almost always due to general medical condition (infections, sepsis, metabolic abnormalities, etc), substance intoxication, substance withdrawal, structural lesions of the brain, faecal impaction, urinary retention, sensory deprivation, sleep deprivation, and postoperative delirium. 4One of the first issues for a newly diagnosed patient is to consider whether the diagnosis is correct. It is important to validate a diagnosis and be certain of its accuracy. Articles » Misdiagnosis » Alternative diagnosis It may be necessary to emphasize that an accurate diagnosis is the key for successful therapy. Empirical and symptomatic drug therapy is generally hazardous and may lead to serious sequel¹ especially in emergency cases. Delirium affecting all age groups from pediatrics to geriatric age: (higher incidence). Delirium in Emergency R, OR, ICU, Out-Patient Clinics, and In-patients wards: Medical, Surgical (Postoperative), OB. Gynecologic, and Pediatrics. Delirium is a condition at the interface of medicine and psychiatry that is all too often owned by neither. The diagnosis of delirium is clinical. It is a clinical Syndrome, not a disease. (R2) Non - Detection Rate/or Misdiagnosis of Delirium: as high as 66% -70%. The author s question: Is it indicating international clinical professional failure? Since diagnosis of delirium is almost always clinical diagnosis. Of all psychiatric diagnoses, delirium demands the most immediate attention since delay in identification and treatment might allow the progression of serious and irreversible pathophysiological changes. The diagnosis of delirium is clinical. No single test is successful. It is an Acute medical emergency syndrome, not a disease. Delirium often is unrecognized or misdiagnosed and commonly is mistaken for dementia, depression, mania, an acute schizophrenic reaction, or part of old age. The use of International Statistical Classification of Diseases and Related Health Problems – 10a rev (ICD-10)22 or DSM-IV20 criteria has contributed to improve the awareness of clinicians for the diagnosis of delirium in clinical settings, although a large proportion of cases remain undiagnosed6-8. The systematic use of delirium scales increase the detection rate of cases. Neuro-Psiquiatr. vol.59 no.2A São Paulo June 2001 Renato Moraes Alves Fabbri1, Marcos Aurélio Moreira2, Regiane Garrido3, Oswaldo Pereira Almeida4 Delirium is defined as a transient, usually reversible, cause of cerebral dysfunction and manifests clinically with a wide range of neuropsychiatric abnormalities Delirium is not a disease but a syndrome with multiple causes that result in a similar constellation of symptoms. Delirium remains one of the most common complicating diagnoses in ailing elderly patients and a leading cause of morbidity, decreased quality of life, prolonged hospital stay, institutionalization and mortality. Despite its clinical importance and health-related costs, it often remains unrecognized or misdiagnosed. 2007 May; 20(3):262-7.PubMed. Diagnosis remains difficult in spite of the improvement of the diagnostic criteria, due to the polymorphism of the clinical signs and fluctuation of vigilance and cognition. 2007 Mar;5(1):7-16.PubMedPsychlo. Neuropsychiat Vieil. Delirium is a common cause of disturbed behavior in medically ill people and is often undetected and poorly managed. It is a condition at the interface of medicine and psychiatry that is all too often owned by neither. Delirium often goes undiagnosed, Non-detection rates as high as 66% have been reported. BMJ 2002; 325:644-647 Sept 21 T M Brown, M F Boyle. BMJ 2002;325:644-647 ( 21 September ) Clinical review ABC of psychological medicine Delirium often is unrecognized or misdiagnosed and commonly is mistaken for Dementia, depression, mania, And acute schizophrenic reaction, or part of Old Age. Kannayiram Alagiakrishnan,(July 28, 2005) Delirium has likely replaced syphilis as “the great imitator,” as its varied presentations have led to misdiagnoses among almost every major category of mental disorders. Delirium is of medical a signifier illness and its development is related to increased
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