Delirium classification

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

Overview

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

Types of Delirium

The classification and definitions of different types of delirium as per the Diagnostic and Statistical Manual of Mental Disorders V (DSM V) is as follows.

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

• Acute: When delirium lasts for a few hours to days.
• Persistent: When delirium lasts for weeks or months.

Based on Severity

• 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.
• Mixed level of activity: A normal level of psychomotor activity, individuals with rapidly fluctuating activity are also included in this category.

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