Psychiatry & Psychotherapy Podcast Psychiatric Approach to Delirium
Oct 8, 2018
Timothy Lee, Loma Linda's Residency Program Director, delves into understanding delirium and its psychiatric implications. He distinguishes between hyperactive and hypoactive delirium, highlighting how symptoms like agitation and confusion can mislead families into thinking of schizophrenia. The discussion extends to the impact of simple infections, especially in the elderly, and the challenges in diagnosing related cognitive issues. Lee emphasizes the importance of careful medication management and tailored recovery strategies for affected patients.
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Defining Hyperactive Delirium
- Delirium is an acute change in cognition or sensorium, often fluctuating and including disorientation.
- Hyperactive delirium features agitation, aggression, hallucinations, and paranoia, differing from psychiatric illness like schizophrenia.
Hypoactive Delirium Is Often Missed
- Hypoactive delirium is more common but often missed due to less dramatic presentation like slowed movement and speech.
- It features confusion and disorientation without verbal or physical agitation, complicating diagnosis.
Delirium Assessment Techniques
- Use orientation to person, place, time, and situation to assess delirium.
- Include concentration, memory recall, and clock drawing tests to detect subtle confusion.