Psychiatry Boot Camp 3.3 Delirium: Clinical Features and Diagnosis
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May 12, 2025 Dr. Mark Oldham, a consult psychiatrist and president-elect of the American Delirium Society, dives into the world of delirium. He explores its clinical features, emphasizing the need for accurate diagnosis, particularly distinguishing it from encephalopathy. Oldham discusses the alarming prevalence of delirium in hospitalized patients, especially the elderly, and its terrifying consequences, such as increased mortality rates. Furthermore, he sheds light on the vital role psychiatry plays in managing delirium, stressing the interplay between psychiatric symptoms and medical conditions.
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Mark Oldham's Delirium Journey
- Mark Oldham found delirium compelling because it links brain, mind, and body dynamically in illness.
- He admires Zbigniew Lepowski's idea of delirium as a "natural experiment" revealing brain-body relationships.
Delirium's Dual Nature
- Delirium sits on the razor's edge between medical and psychiatric categories.
- It defies simple classification as purely psychiatric or purely medical.
Acute Encephalopathy Spectrum
- Acute encephalopathy refers to the pathological brain process presenting as a spectrum from subsyndromal delirium to coma.
- Delirium is one clinical phenotype of acute encephalopathy defined by meeting diagnostic criteria.