Delirium: Issues in diagnosis and management

Abstract

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