Delirium, what ’s in a name?

Delirium has been known since ancient times. Hippocrates [460 –370 Before Common Era (BCE)] may have been the first to describe the syndrome that he called ‘phrenitis’, marked by confusion and restlessness that fluctuated unpredictably and that was associated with physical illness.1 Many other names have been used, including acute mental status change, confusional state, confusion, acute brain dysfunction, brain failure, encephalopathy, postoperative psychosis and acute organic syndrome.1 Of these, the term delirium (derived from the Latin word delirare, deviate from a straight track) has gained acceptance. Besides a more uniform terminology, an important recent achievement includes publication of criteria to define delirium. Although criticized,23 the criteria of theDiagnostic and Statistical Manual of Mental Disorders (5th edition, DSM-5) have become standard.4 According to these criteria, a patient can be considered delirious when all items listed inTable 1 are present at the same time.4 In essence, this means that a patient has acutely developed disturbed attention with other cognitive deficits, which is not solely due to underlying dementia and is caused by a physical condition. Table 1Criteria for delirium according to theDiagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)4A.  A disturbance in attention (i.e. reduced ability to direct, focus, sustain and shift attention) and awareness (reduced orientation to the environment).B.  The dist...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research