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Delirium

Delirium

Vascular surgeons, internists, and neurologists all exist—but why aren’t there any vascular psychiatrists? There certainly is a need.

Of the 3 informative articles included in this special geriatric collection, 1 offers a perspective on the treatment of depression that does not focus on somatotherapy. The others remind us of 2 additional geriatric Ds of importance: drugs and driving.

Depression, anxiety, and delirium are 3 examples of common but frequently challenging areas of distress in pediatric palliative care patients.

I teach doctors and nurses how to assess, treat, and prevent delirium—an acute confusional disorder caused by multiple medical problems that mimics mental illness—but is actually a medical emergency.

Delirium

Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuro­­psychiatric symptoms. Various terms have been used for delirium, such as acute brain disorder, metabolic enceph­alopathy, organic brain syndrome, and ICU psychosis.

Delirium is characterized by an altered level of consciousness, decreased attention span, acute onset, and fluctuating course. Approximately 15% of elderly patients admitted to the hospital have delirium as a presenting or associated symptom. Delirium will develop in another 15% of elderly patients during hospitalization.

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