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Delirium in ICU

Delirium is a psychiatric disorder and as such is classified in the diagnostic and statistical manual of mental disorders (DSM-IV).

  

Differential Diagnosis

The main differential diagnoses involve other processes and syndromes which cause cognitive dysfunction, including:

 

1. Dementia (chronic organic brain syndrome), distinguishing features:

2. Depression

3. Psychosis, including schizophrenia

4. Long-term learning disabilities and a variety of congenital brain disorders

 

Several of the symptoms of delirium can occur in other psychiatric conditions and both states may coexist in the same patient. A careful history is therefore essential to allow differentiation between long-standing cognitive impairment and acute changes.

 

Delirium in the period immediately prior to critical care admission may be the first indication of illness severity, occurring before hypotension and other systemic features develop. Similarly, new onset of delirium in a patient recovering in the intensive care unit, may herald the onset of a new complication.

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