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October 2, 1987

Delirium (Acute Confusional States)

Author Affiliations

From the Department of Psychiatry, University of Toronto.

From the Department of Psychiatry, University of Toronto.

JAMA. 1987;258(13):1789-1792. doi:10.1001/jama.1987.03400130103041

Delirium (acute confusional states), a common and often overlooked psychiatric disorder, can occur at any age, but elderly persons are especially prone to develop it. In later life, it is often a conspicuous feature of systemic or cerebral disease and drug (notably anticholinergic) toxicity, and it may constitute a grave prognostic sign. Its development in a hospitalized patient may interfere with his or her management, disrupt ward routine, and cause medicolegal complications as a result of patient injury. Acute onset of a fluctuating level of awareness, accompanied by sleep-wake cycle disruption, lethargy or agitation, and nocturnal worsening of symptoms, are diagnostic. Early recognition of delirium and treatment of its underlying cause are essential.

(JAMA 1987;258:1789-1792)