Discussion Initial post: Delirium

apa 7th

Respond colleagues by comparing the differential diagnostic features of Frontotemporal Neurocognitive Disorder
to the diagnostic features of delirium

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According to Sadock, Sadock, & Ruiz, (2014), delirium is characterized by short-term confusional state and changes in memory. This can be caused by several conditions such as infection, substance-induced, head trauma, renal disease or sleep deprivation. It is an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech (Sadock, Sadock, & Ruiz, 2014). Delirium is a transient, usually reversible, cause of mental dysfunction and manifests clinically with a wide range of neuropsychiatric abnormalities. It can occur at any age, but it occurs more commonly in patients who are elderly and have a previously compromised mental status (Alagiakrishnan, 2019). At least 10% of older patients who are admitted to the hospital have delirium; 15 to 50% experience delirium at some time during hospitalization. Delirium is also common after surgery and among nursing home residents and intensive care unit (ICU) patients. When delirium occurs in younger people, it is usually due to drug use or a life-threatening systemic disorder (Huang, 2019).

Diagnostic criteria for Delirium

As stated before, delirium can be caused by multiple different conditions which can be confused for another diagnosis if not properly evaluated. The DSM-5 diagnostic criteria for delirium is as follows: Disturbance in attention and awareness. Change in cognition that is not better accounted for by a preexisting, established, or evolving dementia. The disturbance develops over a short period usually hours to days and it tends to fluctuate during the course of the day. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by a direct physiologic consequence of a general medical condition, an intoxicating substance, medication use, or more than one cause. Diagnosis of delirium is clinical, with laboratory and usually imaging tests to identify the cause. (Alagiakrishnan, 2019). Diagnosis of delirium is clinical, with laboratory and usually imaging tests to identify the cause.

Evidence-Based Psychotherapy and Psychopharmacologic treatment

The management of delirium primarily involves identifying and correcting any underlying cause or causes and minimizing the duration and severity of the episode to ensure safety and to restore the patient’s cognitive function (Leigh, et al., 2018). Delirium is characterized by inattention, altered consciousness, and disorganized thinking, and it is associated with various serious adverse outcomes including hospital and ICU mortality, longer duration of mechanical ventilator support, prolonged ICU and hospital stays, and long-term cognitive impairment. For this reason, nurses must appropriately manage delirium to minimize adverse outcomes. Treatment options include both pharmacological and nonpharmacological interventions, although serious illness often requires a pharmacological treatment. The effectiveness of such regimens varies and are not standardized. Non-pharmacological strategies lean towards prevention rather than treatment while pharmacological strategies target prevention or treatment

The most common pharmacological interventions are antipsychotic medications, yet published evidence provides mixed support for their use (Cooper, 2020).

Risks of Different Types of Therapy

We as clinicians and practitioners must always consider the best available evidence and understand the feasibility, appropriateness, meaningfulness, and effectiveness of any intervention to determine whether it is appropriate for our particular patient (Cooper, 2020). Early recognition, increased screening and early intervention have been shown to improve patient outcomes (Leigh, et al., 2018). The management of delirium primarily involves identifying and correcting any underlying cause(s) and minimizing the duration and severity of the episode to ensure safety and to restore the patient’s cognitive function (Leigh, et al., 2018). When pharmacological interventions are used to manage delirium episodes, it is important to be aware of the effectiveness and harms associated with their use (Leigh, et al., 2018). Identifying drug harms that minimize the duration and severity of the delirium episode is of great importance to clinicians and patients. The safe and effective use of pharmacological agents has been associated with improved clinical outcomes, however there are currently no medications that are approved by the FDA for the treatment of delirium (Leigh, et al., 2018). Medical conditions such as urinary tract infection (UTI) should be ruled out. If they risk of choice of medication outweigh the benefits, then another choice should be made for a better patient’s outcome (Leigh, et al., 2018).


Alagiakrishnan, K. (2019). Delirium. Retrieved from https://emedicine.medscape.com/article/288890-overview

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Cooper, Adam S. (2020). Pharmacological Treatments for Delirium in Critically Ill Adults. Cochrane Review Summary. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/

Huang, J. (2019). Delirium. Retrieved https://www.merckmanuals.com/professional/neurologic-disorders/delirium

Leigh, Vivienne, Tufanaru, Catalin, Elliott & Rosalind. (2018). Effectiveness and harms of pharmacological interventions in the treatment of delirium in adults in intensive care units post cardiac surgery: a systematic review protocol. Retrieved from http://ovidsp.dc2.ovid.com.ezp.waldenulibrary.org/

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. PA: Wolters Kluwer.

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