Delirium – Delusional disorder – Delirium

Delirium

What nonsense?

Delusional disorder – altered mental status. The disorder usually occurs and develops rather quickly, for several hours or days. Delirium is characterized by extreme, Changeable changes, including:

• Changes in perception and sensation;
• Difficulties with the possibility:
  • Concentration;
  • Support and shift attention;
  • Rational thinking;
  • Normal functioning of the psyche;
  • Normal communication.

Causes of delirium

There are hundreds of reasons, which can cause delusional disorder. Some of the most common include:

• Serious illness (eg, encephaloma, cancer, renal failure, infarct, stroke, convulsions, high or low blood sugar);
• Serious infections (eg, meningitis, pneumonia, urinary tract infection);
• Toxic effects of drugs taken;
• Injuries (eg, serious head injuries, broken bones or severe pain);
• Alcohol abuse or drug use;
• Refusal of alcohol or drug abuse – withdrawal;
• Exposure to toxins.

Risk factors for delirium

Factors, that may increase the risk of delirium include:

• End-stage disease, especially before death;
• Serious illness, such as AIDS;
• Advanced age;
• Prolonged lack of sleep;
• Severe burns;
• Problems, related to the central nervous system, such as stroke, convulsions, tumors or dementia;
• Operation;
• Hospitalization;
• Diseases of the vision or hearing;
• Stillness;
• Dehydration;
• Severe constipation;
• Memory impairment;
• Deficiency of certain vitamins.

Symptoms of delirium

Symptoms of delirium usually occurs quickly and can last for several days, weeks or longer. They also differ in the severity, depending on the cause. Symptoms are often worse at night and may include:

• Inability to concentrate;
• Confusion;
• Problems with memory;
• Speech disorder;
• Disorientation, in particular, inability to perceive:
  • Times of Day;
  • The people around them;
  • His condition.

Severe symptoms include:

• Misinterpretation of events and people around them – eg, the patient finds, people who in reality want to help him, They are trying to harm him;
• Illusions – eg, the patient considers himself or another person by someone else;
• Hallucinations;
• Emotional disorders – eg, the patient suddenly becomes very angry, closed, He feels a sense of fear for no apparent reason.

Diagnosis of delirium

The doctor will ask about your symptoms and medical history, and perform a physical examination. The doctor will ask questions about the:

• The presence of injury or illness;
• Use of drugs or narcotics;
• Time changes in mental status;
• How and how fast the mental state changed.

The diagnosis will be delivered on the basis of information, that the doctor finds during an inspection. To determine the cause of delirium doctor may require additional data, for which can be assigned to various tests:

• Blood tests, that:
  • Search for signs of infection;
  • Determine the level of electrolytes, including sodium , potassium and calcium;
  • Determine the level of oxygen in the blood;
  • To determine the level of glucose in the blood;
  • To determine levels of vitamins, such as vitamin B12, folic acid and thiamine;
  • Rate levels of drugs in the blood;
  • Find toxins or drugs;
• Testing the function of kidneys and liver;
• Thyroid function tests;
• Spinnomozgovaya puncture – to look for signs of infection , inflammation, injury, and / or cancer in the brain or spinal cord;
• Analysis of urine and isolating bacteria cultures – to look for signs of infection.

The pictures of internal organs can also help determine the cause of delirium. To take pictures of internal organs, the following methods:

• Chest X-ray, to look for signs of pneumonia;
• Electrocardiogram (ECG) – for the study of the electrical activity of the heart and heart disease research;
• CT scan;
• MRT;
• Electroencephalogram (EEG) – for signs of seizures.

Treatment of delirium

Delusional disorder is eliminated by identifying and treating the underlying cause of it. Then the symptoms are eliminated with medication, psychological counseling and support activities.

Methods of treatment of delirium may include:

Medication when delusional disorder

Preparations, used to treat the symptoms of delirium include:

• Antipsihoticheskie drugs;
• Benzodiazepines – used to treat delirium, caused by alcohol withdrawal;
• Cholinergic drugs – used to treat delirium, induced by administration of anticholinergic drugs, used to treat stomach cramps, gut spasms, bladder and other diseases;
• Vitamins – appointed, if delirium develops due to the low level of vitamins.

If you are taking medicines, which worsen the mental state, the doctor can stop taking them.

Psychological help with delusional disorder at

Psychological therapy can help the patient:

• Feel safer and more comfortable;
• Improve the basic body functions;
• Calm down and reduce the feeling of anxiety.

Activities to support and care

This type of treatment can help the patient to adapt to its environment and to reduce the feeling of anxiety. Examples of such measures include:

• The clock and calendar in the sickroom;
• Darkening the room at night and plenty of natural light during daytime hours;
• Keeping in the sickroom of peace and quiet;
• Reminder patient who he, where and why is;
• Placing familiar objects around the patient – family photographs or objects from home.

Prevention of delirium

A number of steps can help prevent delirium in hospitalized patients at risk for its development. These steps include:

• A reminder, why the patient is in the hospital;
• Listening to relaxing music;
• Perform a very light exercise (if recommended by your doctor);
• Use of hearing aids and glasses or contact lenses (if necessary);
• Consumption of large amounts of fluid (to prevent dehydration).

Delirium is difficult to prevent, because it has so many reasons, and can occur suddenly.