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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2002 December;43(4):275-80

language: Italian

Delirium. Clinical and therapeutic features

Rocca P., Bettonte D., Cirla M., Marchiaro L., Rivoira E., Bogetto F.


The purpose of this paper is to review the clinical features, epidemiolgy, risk factors and therapy of delirium. The review, presented in two parts, clinical features and treatment, is followed by a discussion and it is based on the results of a Medline search for articles published in the last years. Delirium is a complex neuropsychiatric syndrome with an acute onset and fluctuating course. It is characterized by a disturbance in consciousness and change in cognition that develops over a short period of time and tends to fluctuate over the course of the day. Treatment requires interdisciplinary efforts that address both the underlying causes and the symptoms of delirium. Nonpharmacologic care is an important but often ignored element in the management of delirium. Pharmacologic intervention is essential when it appears that patients may harm themselves or others and when nonpharmacologic methods have failed. Neuroleptics continue to be used as first line treatment, but benzodiazepines are indicated in specific situations. Delirium is a common and important form of psychopathology in the elderly. Optimal management of delirium primarily depends on reducing modifiable risk factors and detecting high risk cases early.

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