[Delirium in psychiatric consultation services].

Abstract

Background: Inquiries about delirium are a very common request in psychiatric consultation and liaison services (CL).

Objectives: What practical procedures can be derived from current recommendations?

Methods: Evaluation of current guidelines and literature recommendations, as well as of the experiences in interdisciplinary planning of delirium management at various hospitals and of comments of participants in the author's workshops.

Results: Delirium is seen as a major burden in the treatment of seriously ill patients across all medical disciplines. There are national and international medical guideline recommendations that unanimously recommend institutional delirium management, which follows a standardized approach for the respective department to minimize risk and prevent delirium. Cognitive deficits can follow delirium, especially in old age. Pathophysiological models can support the indication for treatment. Nonpharmacological techniques are effective; pharmacological steps should be carefully considered. Communication with those affected and their relatives and the transition upon discharge or transfer should be explicitly included.

Conclusions: The CL can support steps and department-specific optimization of multiprofessional and delirium management, especially differential psychopharmacotherapy. Further efforts in the implementation of effective delirium management are also possible institutionally in order to improve the prognosis and quality of life of those affected.