(Mental Health)

Overview

• Syndrome of acute confusion characterized by fluctuations in awareness, cognition, and attention
• Elderly patients (>65 years old) and hospitalized patients are most susceptible
• Typically secondary to → metabolic causes (hypercalcaemia, hypoglycaemia, hyponatraemia, dehydration), infections (UTIs, pneumonia), trauma (hip fractures), drugs, change in environment, constipation, urinary retention (may be due to BPH - may present with suprapubic distension and tenderness)

Delirium Tremens → extreme form of acute alcohol withdrawal. Usually develops around 72 hrs after ceasing alcohol intake. Presents with hallucinations and fluctuating consciousness levels. Tx with chlordiazeproxide and pabrinex.

Making Diagnosis

Clinical Features:

• Acute alteration in the level of awareness and attention (decreased consciousness)
  • Impairment of consciousness = distinguishes delirium and dementia
• Hallucinations
• Cognitive Deficits (eg. memory problems)
• Agitation
• Severity of symptoms fluctuates throughout the day and worsens in the evening
• May be hypoactive (25% - decreased psychomotor activity) or hyperactive (75% - increased psychomotor activity)
  • Hypoactive ⇒ withdrawn, lethargic, slow to respond
• Delirium vs Dementia