Delirium classification: Difference between revisions

	Delirium Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Delirium from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case #1
Delirium On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Delirium All Images X-rays Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Delirium
CDC on Delirium
Delirium in the news
Blogs on Delirium
Directions to Hospitals Treating Delirium
Risk calculators and risk factors for Delirium

Revision as of 09:50, 11 April 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Pratik Bahekar, MBBS [3]; Vishal Khurana, M.B.B.S., M.D. [4]

Delirium is classified on the basis of etiology, duration and severity.

Delirium may be classified into:

Diagnostic and Statistical Manual (DSM)-5	World Health Organization's International Classification of Diseases (10th revision)	ICD-10
Disturbance in attention and awareness (reduced ability to direct, focus, shift attention and reduced orientation to envinment) Initiation of disturbance over a short period of time during several hours or days with fluctuation in severity over a day Disturbance in cognition (memory deficit, disorientation, language, visuospatial ability, perception Evolving neurocognitive disorder Disturbance due to medical condition, substance intoxication, or withdrawal, toxin exposure	Disturbance in cognition Impairment of immediate recall and recent memory Disorientation to time, place, person	Disturbance in sleep wake cycle Psychomotor disturbances Emotional disturbances Upper limit time: 6 months

Classification based on	Types
Etiology	Substance intoxication delirium
	Substance withdrawal delirium
	Delirium caused by another medical condition
	Delirium caused by multiple etiologies
Duration	Acute
Duration	Persistent
Severity	Hyperactive
	Hypoactive
	Mixed level of activity

Hyperactive: An increased psychomotor activity, which may co-occur with, increased mood lability, agitation, and/or non cooperative attitude towards medical treatment.
Hypoactive: A hypoactive level of psychomotor activity, which may exist along with increased sluggishness, lethargy or stupor, inattentiveness and motor slowness and is much more common among ICU admitted patients with severe disease.^[1]
Mixed level of activity: A normal level of psychomotor activity, individuals with rapidly fluctuating activity are also included in this category.^[2]

Some authors have described a fourth type of delirium called as subsyndromal delirium, which is an incomplete form of delirium.^[3]

↑ Krewulak, Karla D.; Stelfox, Henry T.; Leigh, Jeanna Parsons; Ely, E. Wesley; Fiest, Kirsten M. (2018). "Incidence and Prevalence of Delirium Subtypes in an Adult ICU". Critical Care Medicine. 46 (12): 2029–2035. doi:10.1097/CCM.0000000000003402. ISSN 0090-3493.
↑ Inouye, SK.; Westendorp, RG.; Saczynski, JS. (2013). "Delirium in elderly people". Lancet. doi:10.1016/S0140-6736(13)60688-1. PMID 23992774. Unknown parameter |month= ignored (help)
↑ Young, J.; Inouye, SK. (2007). "Delirium in older people". BMJ. 334 (7598): 842–6. doi:10.1136/bmj.39169.706574.AD. PMID 17446616. Unknown parameter |month= ignored (help)

@@ Line 72: / Line 72: @@
 | colspan="2" align="Left"| Mixed level of activity
 |}
-===Based on Etiology===
-* '''Substance intoxication delirium''': Diagnosis of [[substance intoxication]] [[delirium]] is made rather than substance [[intoxication]], when the symptoms in Criteria A and C predominate and are severe enough to require clinical attention.
-* '''Substance withdrawal delirium''': Diagnosis of [[substance withdrawal]] [[delirium]] is made rather than substance withdrawal, when the [[symptoms]] in Criteria A and C predominate and are severe enough to require clinical attention.
-* '''Delirium caused by another medical condition''': When delirium is caused by another medical condition.
-* '''Delirium caused by multiple etiologies''': [[Delirium]] is a consequence of multiple causes e.g. [[medical]] [[condition]] plus [[substance intoxication]] or side effect of [[medications]].
 ===Based on Duration===