Delirium

Bart Sheehan
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Abstract

Delirium is one of the most common psychiatric problems encountered in elderly medical inpatients. It involves a fluctuating cognitive impairment with reduced alertness and often with poorly formed delusions and/or visual hallucinations. The main differential diagnosis is from dementia, although delirium is more likely to develop in patients with existing dementia. Almost any medical condition that affects brain function may cause delirium. Infection is the most common cause, and it is important to consider prescribed drugs as a cause and to remember drug and alcohol withdrawal. Imperatives in management are first to keep the patient safe from harm (they may wander or put themselves in danger), and second to find and correct the cause. Urgent medical investigation and treatment is required as long periods of delirium put the patient at risk of harm, including permanent cognitive impairment.
精神错乱
谵妄是老年住院患者最常见的精神问题之一。它包括波动性认知障碍,警觉性降低,常伴有形成不良的妄想和/或视觉幻觉。主要的鉴别诊断是来自痴呆症,尽管谵妄更有可能在已有痴呆症的患者中发展。几乎任何影响大脑功能的疾病都可能导致谵妄。感染是最常见的原因,重要的是要考虑到处方药的原因,并记住药物和酒精的戒断。管理的当务之急首先是保护病人免受伤害(他们可能会四处游荡或将自己置于危险之中),其次是找到并纠正原因。需要紧急进行医疗调查和治疗,因为长时间的谵妄会使患者面临伤害的危险,包括永久性认知障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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