Delirium: Issues in diagnosis and management

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium, acute confusion and management. Additional articles identified by hand-searching in major journals of medicine and psychiatry, and a review of references cited within these sources supplemented the search. In this article, the available published literature regarding the diagnosis, prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines, including nursing, psychiatry, neurology and primary care, as well as the cooperation and significant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium.D\ue9lire est une perturbation. de conscience, cognition et de perception qui se produit fr\ue9quemment en m\ue9dicalement malades. M\ueame s\u2019il est associ\ue9 \ue0 une augmentation de la morbidit\ue9 et mortalit\ue9, Il est souvent pas reconnus et trait\ue9 par les m\ue9decins. Litt\ue9rature recherches ont \ue9t\ue9 effectu\ue9es en utilisant MEDLINE avec les mots cles/phrases suivantes: d\ue9lire, confusion aigue, et de Gestion. Articles suppl\ue9mentaires identifi \ue9 \ue0 la main dans les grandes feuilles de m\ue9decine et de psychiatrie, la recherche et d\u2019un examen des r\ue9f\ue9rences cit\ue9es dans ces sources compl\ue9t\ue9 la recherche. Dans cet article, le disponible publi\ue9 litt\ue9rature concernant le diagnostic, la pr\ue9vention et traitement de d\ue9lire est syst\ue9matiquement examin\ue9. La pr\ue9vention et strat\ue9gies de traitement ne doivent pas \ueatre complexes ou on\ue9reux mais n\ue9cessite interventions bien coordonn\ue9es de plusieurs disciplines, y compris les soins infi rmiers, psychiatrie, neurologie et de soins primaires, ainsi que la coop\ue9ration et effort important de la famille et amis. Agents antipsychotiques atypiques offre certains avantages sur Halop\ue9ridol et dans un nombre limit\ue9 d\u2019\ue9tudes s\u2019affi chent sans danger effi cace et de d\ue9lire

Delirium: Issues in diagnosis and management

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium, acute confusion and management. Additional articles identified by hand-searching in major journals of medicine and psychiatry, and a review of references cited within these sources supplemented the search. In this article, the available published literature regarding the diagnosis, prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines, including nursing, psychiatry, neurology and primary care, as well as the cooperation and significant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium

Frequency and pattern of violence towards healthcare workers in a mental health facility

Background: Workplace violence is a well-recognized concern for healthcare workers and can broadly be divided into physical and psychological types.Objective: The purpose of this study was to investigate the frequency and pattern of violence towards healthcare workers in a mental health facility in Maiduguri, North-East Nigeria.Methodology: It was a descriptive study that involved members of staff who belonged to the Departments of Nursing Services and Mental Health, Federal Neuro-Psychiatric Hospital Maiduguri, Borno State, Nigeria. Recruitment was via convenience method over four weeks in the month of December 2013, using a self-administered questionnaire containing 26 questions, with a section for socio-demographic data, adapted from aggression questionnaire designed by Hasan Hüseyin Eker, et al.Results: Overall, 71 out of 114 members of staff (62.3%) belonging to both Departments of Nursing Services and Mental Health of the hospital were involved in the study. More than two-thirds (69.0%) of the participants were males, and more than half (53.5%) reported being exposed to violence in the preceding 12months. Among those exposed to violence, 92.1% of them reported verbal, and 7.9% physical violence. Nearly a quarter (23.7%) of those exposed to violence reported being negatively affected.Conclusion: Violence by patients and their relations in this study setting was common but mainly verbal. Exposure to violence may result in negative post-exposure consequences.Keywords: Maiduguri, Mental Health Department, Nigeria, Nursing Service

Delirium: Issues in diagnosis and management

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium, acute confusion and management. Additional articles identified by hand-searching in major journals of medicine and psychiatry, and a review of references cited within these sources supplemented the search. In this article, the available published literature regarding the diagnosis, prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines, including nursing, psychiatry, neurology and primary care, as well as the cooperation and significant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium.Délire est une perturbation. de conscience, cognition et de perception qui se produit fréquemment en médicalement malades. Même s’il est associé à une augmentation de la morbidité et mortalité, Il est souvent pas reconnus et traité par les médecins. Littérature recherches ont été effectuées en utilisant MEDLINE avec les mots cles/phrases suivantes: délire, confusion aigue, et de Gestion. Articles supplémentaires identifi é à la main dans les grandes feuilles de médecine et de psychiatrie, la recherche et d’un examen des références citées dans ces sources complété la recherche. Dans cet article, le disponible publié littérature concernant le diagnostic, la prévention et traitement de délire est systématiquement examiné. La prévention et stratégies de traitement ne doivent pas être complexes ou onéreux mais nécessite interventions bien coordonnées de plusieurs disciplines, y compris les soins infi rmiers, psychiatrie, neurologie et de soins primaires, ainsi que la coopération et effort important de la famille et amis. Agents antipsychotiques atypiques offre certains avantages sur Halopéridol et dans un nombre limité d’études s’affi chent sans danger effi cace et de délire

An Appraisal of the Mental Health Curriculum for Undergraduates in Nigerian Medical Schools

Background: Nigerian Medical Schools need to attain international bes t prac t i ces in teaching psychiatry. The supply or availability of mental health professionals demands strong medical school psychiatry curriculum. The study therefore aims to investigate the level of adherence of Nigerian Medical Schools to the requirements of the regulatory bodies with regard to the teaching of Psychiatry at the undergraduate level.Methods: A short seven item questionnaire was distributed to examiners in the Faculty of Psychiatry in April 2011, during the Fellowship Examination of the West African College of Physicians.Results: Thirteen medical schools, spread across the six geopolitical zones of Nigeria were represented. Ten of the schools (79.6%) reported having a separate  department of psychiatry. Only five of the medical schools provide some teaching in behavioural sciences during the preclinical years. Seven schools have no ward round teaching, most have neither tutorials nor seminars and majority (84.6%) do not conduct an independent examination in psychiatry. Conclusions: Ppsychiatry curriculum is being selectively implemented in Nigerian Medical Schools.Keywords : Psychiatry , Curriculum, Medical schools, Nigeria, Teachin