Delirium

**Delirium** (formerly **acute confusional state**, an ambiguous term wey now dem discourage) be a specific state of acute confusion attributable to de direct physiological consequence of a medical condition, effects of a psychoactive substance, anaa multiple causes, wich dey usually develop over de course of hours to days. As a syndrome, delirium dey present plus disturbances in attention, awareness, den higher-order cognition. People plus delirium fi experience oda neuropsychiatric disturbances wey dey include changes in psychomotor activity (e.g., hyperactive, hypoactive, anaa mixed level of activity), disrupted sleep-wake cycle, emotional disturbances, disturbances of consciousness, anaa altered state of consciousness, as well as perceptual disturbances (e.g., hallucinations den delusions), although dese features no be required for diagnosis.

Diagnostically, delirium dey encompass both de syndrome of acute confusion den ein underlying organic process dem know as an acute encephalopathy. De cause of delirium fi be either a disease process *inside* de brain anaa a process *outside* de brain wey nonetheless dey affect de brain. Delirium fi be de result of an underlying medical condition (e.g., infection anaa hypoxia), side effect of a medication such as diphenhydramine, promethazine, den dicyclomine, substance intoxication (e.g., opioids anaa hallucinogenic deliriants), substance withdrawal (e.g., alcohol anaa sedatives), anaa from multiple factors wey dey affect one ein overall health (e.g., malnutrition, pain, etc.). In contrast, de emotional den behavioral features secof primary psychiatric disorders (e.g., as insyd schizophrenia, bipolar disorder) no dey meet de diagnostic criteria for 'delirium'.

Delirium fi be difficult to diagnose widout first establishing a person ein usual mental function anaa 'cognitive baseline'. Delirium fi be confused plus chaw psychiatric disorders anaa chronic organic brain syndromes secof chaw overlapping signs den symptoms in common plus dementia, depression, psychosis, etc. Delirium fi occur in persons plus existing mental illness, baseline intellectual disability, anaa dementia, entirely unrelated to any of dese conditions. Delirium often be confused plus schizophrenia, psychosis, organic brain syndromes, den more, secof similar signs den symptoms of dese disorders.

Treatment of delirium dey require identifying den managing de underlying causes, managing delirium symptoms, den reducing de risk of complications. Insyd sam cases, dem dey use temporary anaa symptomatic treatments to comfort de person anaa to facilitate oda care (e.g., dey prevent people from pulling out a breathing tube). Antipsychotics no be supported for de treatment anaa prevention of delirium among those wey dey insyd hospital; however, dem fi be used insyd cases wer na a person get distressing experiences such as hallucinations anaa if de person dey pose a danger to demaselves anaa odas. Wen delirium be caused by alcohol anaa sedative-hypnotic withdrawal, dem typically dey use benzodiazepines as a treatment. Der be evidence say de risk of delirium insyd hospitalized people fi be reduced by non-pharmacological care bundles (spy ). According to de text of DSM-5-TR, although delirium dey affect 1–2% per of de overall population, 18–35% of adults wey dey present to de hospital go get delirium, den delirium go occur insyd 29–65% of people wey be hospitalized. Delirium dey occur insyd 11–51% of older adults after surgery, insyd 81% of those insyd de ICU, den insyd 20–22% of individuals insyd nursing homes anaa post-acute care settings. Among those wey dey require critical care, delirium be a risk factor for death within de next year.

Secof de confusion wey be caused by similar signs den symptoms of delirium plus oda neuropsychiatric disorders like schizophrenia den psychosis, treating delirium fi be difficult, den even fi cause death of de patient secof dem dey treat am plus de wrong medications.

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