Delirium - Knowledge

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checked for delirium every day (usually twice or more a day) using a validated clinical tool. Key elements of detecting delirium in the ICU are whether a person can pay attention during a listening task and follow simple commands. The two most widely used are the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC). Translations of these tools exist in over 20 languages and are used ICUs globally with instructional videos and implementation tips available. For children in need of intensive care there are validated clinical tools adjusted according to age. The recommended tools are preschool and pediatric Confusion Assessment Methods for the ICU (ps/pCAM-ICU) or the Cornell Assessment for Pediatric Delirium (CAPD) as the most valid and reliable delirium monitoring tools in critically ill children or adolescents.

689: 2164:; Henderson, A.S.; Strotzka, H.; Lipowski, Z.; Yu-cun, Shen; You-xin, Xu; Strömgren, E.; Glatzel, J.; Kühne, G.-E.; Misès, R.; Soldatos, C.R.; Pull, C.B.; Giel, R.; Jegede, R.; Malt, U.; Nadzharov, R.A.; Smulevitch, A.B.; Hagberg, B.; Perris, C.; Scharfetter, C.; Clare, A.; Cooper, J.E.; Corbett, J.A.; Griffith Edwards, J.; Gelder, M.; Goldberg, D.; Gossop, M.; Graham, P.; Kendell, R.E.; Marks, I.; Russell, G.; Rutter, M.; Shepherd, M.; West, D.J.; Wing, J.; Wing, L.; Neki, J.S.; Benson, F.; Cantwell, D.; Guze, S.; Helzer, J.; Holzman, P.; Kleinman, A.; Kupfer, D.J.; Mezzich, J.; Spitzer, R.; Lokar, J. 1476:

undiagnosed dementia (i.e., the dementia was present before the delirium, rather than caused by it). In prospective studies, people hospitalised from any cause appear to be at greater risk of dementia and faster trajectories of cognitive decline, but these studies did not specifically look at delirium. In the only population-based prospective study of delirium, older persons had an eight-fold increase in dementia and faster cognitive decline. The same association is also evident in persons already diagnosed with Alzheimer's dementia.

1369:) method" can be an effective management technique for older people with delirium, where abnormal behaviors (including hallucinations and delusions) are tolerated and unchallenged, as long as caregiver safety and the safety of the person experiencing delirium is not threatened. Implementation of this model may require a designated area in the hospital. All unnecessary attachments are removed to anticipate for greater mobility, and agitation is prevented by avoiding excessive reorientation/questioning. 1243:

medical professionals such as a trained nurse, and volunteers, who are overseen by the nurse. The volunteer program equips each trainee with the adequate basic geriatric knowledge and interpersonal skills to interact with patients. Volunteers perform the range of motion exercises, cognitive stimulation, and general conversation with elderly patients who are staying in the hospital. Alternative effective delirium prevention programs have been developed, some of which do not require volunteers.

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non-verbal deescalation techniques may be required to offer reassurances and calm the person experiencing delirium. Restraints should rarely be used as an intervention for delirium. The use of restraints has been recognized as a risk factor for injury and aggravating symptoms, especially in older hospitalized people with delirium. The only cases where restraints should sparingly be used during delirium is in the protection of life-sustaining interventions, such as endotracheal tubes.

1358:, low blood pressure, low glucose, dehydration), interventions include optimizing the hospital environment by reducing ambient noise, providing proper lighting, offering pain relief, promoting healthy sleep-wake cycles, and minimizing room changes. Although multicomponent care and comprehensive geriatric care are more specialized for a person experiencing delirium, several studies have been unable to find evidence showing they reduce the duration of delirium. 1508:

delirium. Since the advent of validated and easy-to-implement delirium instruments for people admitted to the ICU such as the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC), it has been recognized that most ICU delirium is hypoactive, and can easily be missed unless evaluated regularly. The causes of delirium depend on the underlying illnesses, new problems like

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classes, this may be valuable time that would be used working to support the family. This leads to a disproportionate amount of individuals who experience delirium being from marginalized identities. Programs such as the Hospital Elder Life Program can attempt to combat these societal issues by providing additional support and education about delirium that may not otherwise be accessible.

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2020. Delirium detection in general acute care settings can be assisted by the use of validated delirium screening tools. Many such tools have been published, and they differ in a variety of characteristics (e.g., duration, complexity, and need for training). It is also important to ensure that a given tool has been validated for the setting where it is being used.

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differ regarding underlying pathophysiology, treatment needs, functional prognosis, and risk of mortality, though inconsistent subtype definitions and poorer detection of hypoactive subtypes may influence the interpretation of these findings. The notion of unifying hypoactive and hyperactive states under the construct of delirium is commonly attributed to Lipowski.

1024:(EEG) allows for continuous capture of global brain function and brain connectivity, and is useful in understanding real-time physiologic changes during delirium. Since the 1950s, delirium has been known to be associated with slowing of resting-state EEG rhythms, with abnormally decreased background alpha power and increased theta and delta frequency activity. 962:(CSF) in delirium are difficult to perform. Apart from the general difficulty of recruiting participants who are often unable to give consent, the inherently invasive nature of CSF sampling makes such research particularly challenging. However, a few studies have managed to sample CSF from persons undergoing spinal anesthesia for elective or emergency surgery. 989:(MRI), the large variety in imaging-based findings has limited our understanding of the changes in the brain that may be linked to delirium. Some challenges associated with imaging people diagnosed with delirium include participant recruitment and inadequate consideration of important confounding factors such as history of 1235:

age 65, with a cognitive impairment, undergoing major surgery, or with severe illness. Routine delirium screening is recommended in such populations. It is thought that a personalized approach to prevention that includes different approaches together can decrease rates of delirium by 27% among the elderly.

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Delirium may be prevented and treated by using non-pharmacologic approaches focused on risk factors, such as constipation, dehydration, low oxygen levels, immobility, visual or hearing impairment, sleep disturbance, functional decline, and by removing or minimizing problematic medications. Ensuring a

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Any serious, acute biological factor that affects neurotransmitter, neuroendocrine, or neuroinflammatory pathways can precipitate an episode of delirium in a vulnerable brain. Certain elements of the clinical environment have also been associated with the risk of developing delirium. Some of the most

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Sepulveda, E.;Franco, J.G.;Trzepacz, P.T.;Gaviria, A.M.;Meagher, D.J.;Palma, J.;Viñuelas, E.;Grau, I.;Vilella, E.;de Pablo, J. (2016). Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: Diagnostic accuracy study. BMC Psychiatry, 16 (1), art. no. 167.

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delirium prevalence on admission ranged 10–31%. About 5–10% of older adults who are admitted to hospital develop a new episode of delirium while in hospital. Rates of delirium vary widely across general hospital wards. Estimates of the prevalence of delirium in nursing homes are between 10% and 45%.

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The current evidence suggests that software-based interventions to identify medications that could contribute to delirium risk and recommend a pharmacist's medication review probably reduces incidence of delirium in older adults in long-term care. The benefits of hydration reminders and education on

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and dopamine signaling), reversible fall in somatostatin, and increased cortisol. The leading "neuroinflammatory hypothesis" (where neurodegenerative disease and aging leads the brain to respond to peripheral inflammation with an exaggerated CNS inflammatory response) has been described, but current

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Individuals with multiple and/or significant predisposing factors are at high risk for an episode of delirium with a single and/or mild precipitating factor. Conversely, delirium may only result in low risk individuals if they experience a serious or multiple precipitating factors. These factors can

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Treatment of delirium requires identifying and managing the underlying causes, managing delirium symptoms, and reducing the risk of complications. In some cases, temporary or symptomatic treatments are used to comfort the person or to facilitate other care (e.g., preventing people from pulling out a

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The implications of such an "acquired dementia-like illness" can profoundly debilitate a person's livelihood level, often dismantling his/her life in practical ways like impairing one's ability to find a car in a parking lot, complete shopping lists, or perform job-related tasks done previously for

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In older persons admitted to hospital, individuals experiencing delirium are twice as likely to die than those who do not (meta-analysis of 12 studies). In the only prospective study conducted in the general population, older persons reporting delirium also showed higher mortality (60% increase). A

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medications prevent delirium. A review of intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery showed little or no difference in postoperative delirium according to the type of anaesthetic maintenance agents

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An estimated 30–40% of all cases of delirium could be prevented in cognitively at-risk populations, and high rates of delirium reflect negatively on the quality of care. Episodes of delirium can be prevented by identifying hospitalized people at risk of the condition. This includes individuals over

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Delirium has been commonly classified into psychomotor subtypes of hypoactive, hyperactive, and mixed level of activity, though studies are inconsistent as to their prevalence. Hypoactive cases are prone to non-detection or misdiagnosis as depression. A range of studies suggests that motor subtypes

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Smith, Heidi A. B.; Besunder, James B.; Betters, Kristina A.; Johnson, Peter N.; Srinivasan, Vijay; Stormorken, Anne; Farrington, Elizabeth; Golianu, Brenda; Godshall, Aaron J.; Acinelli, Larkin; Almgren, Christina; Bailey, Christine H.; Boyd, Jenny M.; Cisco, Michael J.; Damian, Mihaela (February

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Between 50% and 70% of people admitted to the ICU have permanent problems with brain dysfunction similar to those experienced by people with Alzheimer's or those with a traumatic brain injury, leaving many ICU survivors permanently disabled. This is a distressing personal and public health problem

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with minimal noise and light at night, minimizing room relocation, having familiar objects like family pictures, providing earplugs, and providing adequate nutrition, pain control, and assistance toward early mobilization) may also aid in preventing delirium. Research into pharmacologic prevention

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at Yale University, founded the Hospital Elder Life Program (HELP) which has since become recognized as a proven model for preventing delirium. HELP prevents delirium among the elderly through active participation and engagement with these individuals. There are two working parts to this program,

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There is evidence that delirium detection and coding rates can show improvements in response to guidelines and education; for example, whole country data in England and Scotland (sample size 7.7M patients per year) show that there were large increases (3-4 fold) in delirium coding between 2012 and

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is also known to cause delirium (often termed sepsis-associated encephalopathy). Animal models used to study the interactions between prior degenerative disease and overlying systemic inflammation have shown that even mild systemic inflammation causes acute and transient deficits in working memory

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Leentjens AF, Rundell J, Rummans T, Shim JJ, Oldham R, Peterson L, et al. (August 2012). "Delirium: An evidence-based medicine (EBM) monograph for psychosomatic medicine practice, commissioned by the Academy of Psychosomatic Medicine (APM) and the European Association of Consultation Liaison

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Institutionalization was also twice as likely after an admission with delirium (meta-analysis of seven studies). In a community-based population examining individuals after an episode of severe infection (though not specifically delirium), these persons acquired more functional limitations (i.e.,

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Family, friends, and other caregivers can offer frequent reassurance, tactile and verbal orientation, cognitive stimulation (e.g. regular visits, familiar objects, clocks, calendars, etc.), and means to stay engaged (e.g. making hearing aids and eyeglasses readily available). Sometimes verbal and

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The most recent area of the hospital in which delirium is just beginning to be monitored routinely in many centers is the Emergency Department, where the prevalence of delirium among older adults is about 10%. A systematic review of delirium in general medical inpatients showed that estimates of

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People who are in the ICU are at greater risk of delirium, and ICU delirium may lead to prolonged ventilation, longer stays in the hospital, increased stress on family and caregivers, and an increased chance of death. In the ICU, international guidelines recommend that every person admitted gets

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Guidelines recommend that delirium should be diagnosed consistently when present. Much evidence reveals that in most centers delirium is greatly under-diagnosed. A systematic review of large scale routine data studies reporting data on delirium detection tools showed important variations in tool

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More emphasis is placed on regular screening over the choice of tool used. This, coupled with proper documentation and informed awareness by the healthcare team, can affect clinical outcomes. Without using one of these tools, 75% of ICU delirium can be missed by the healthcare team, leaving the

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The association between delirium and dementia is complex. The systematic review estimated a 13-fold increase in dementia after delirium (meta-analysis of two studies). However, it is difficult to be certain that this is accurate because the population admitted to hospital includes persons with

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Prevention efforts often fall on caregivers. Caregivers often have a lot expected of them and this is where socioeconomic status plays a role in prevention. If prevention requires constant mental stimulation and daily exercise, this takes time out of the caregiver's day. Based on socioeconomic

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criteria are often the standard for diagnosing delirium clinically. However, early recognition of delirium's features using screening instruments, along with taking a careful history, can help in making a diagnosis of delirium. A diagnosis of delirium generally requires knowledge of a person's

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The methode of phisicke conteyning the causes, signes, and cures of invvard diseases in mans body from the head to the foote. VVhereunto is added, the forme and rule of making remedies and medicines, which our phisitians commonly vse at this day, with the proportion, quantitie, & names of

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of brain regions responsible for normal processing of executive function, sensory processing, attention, emotional regulation, memory, and orientation, differences in autoregulation of the vascular vessels in the brain, reduction in cerebral blood flow and possible changes in brain metabolism

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The highest rates of delirium (often 50–75% of people) occur among those who are critically ill in the intensive care unit (ICU). This was historically referred to as "ICU psychosis" or "ICU syndrome"; however, these terms are now widely disfavored in relation to the operationalized term ICU

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From such evidence, a 2018 systematic review proposed a conceptual model that delirium results when insults/stressors trigger a breakdown of brain network dynamics in individuals with low brain resilience (i.e. people who already have underlying problems of low neural connectivity and/or low

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There is substantial evidence that delirium results in long-term poor outcomes in older persons admitted to hospital. This systematic review only included studies that looked for an independent effect of delirium (i.e., after accounting for other associations with poor outcomes, for example

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symptoms include hyper-vigilance, restlessness, fast or loud speech, irritability, combativeness, impatience, swearing, singing, laughing, uncooperativeness, euphoria, anger, wandering, easy startling, fast motor responses, distractibility, tangentiality, nightmares, and persistent thoughts

530:: Sleep disturbances in delirium reflect disruption in both sleep/wake and circadian rhythm regulation, typically characterized by fragmented sleep or even sleep-wake cycle reversal (i.e., active at night, sleeping during the day), including as an early sign preceding the onset of delirium. 316:

are not supported for the treatment or prevention of delirium among those who are in hospital; however, they may be used in cases where a person has distressing experiences such as hallucinations or if the person poses a danger to themselves or others. When delirium is caused by alcohol or

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For inpatients in a hospital setting, numerous approaches have been suggested to prevent episodes of delirium including targeting risk factors such as sleep deprivation, mobility problems, dehydration, and impairments to a person's sensory system. Often a 'multicomponent' approach by an

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levels, either as a state between normal wakefulness/alertness and coma (hypoactive) or as a state of heightened psychophysiological arousal (hyperactive). It can also alternate between the two (mixed level of activity). While requiring an acute disturbance in attention, awareness, and

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Treating delirium that is already established is challenging and for this reason, preventing delirium before it begins is ideal. Prevention approaches include screening to identify people who are at risk, and medication-based and non-medication based (non-pharmacological) treatments.

1013:(including cerebral tissue oxygenation and glucose hypometabolism). Altogether, these changes in MRI-based measurements invite further investigation of the mechanisms that may underlie delirium, as a potential avenue to improve clinical management of people with this condition. 1269:

Melatonin and other pharmacological agents have been studied for delirium prevention, but evidence is conflicting. Avoidance or cautious use of benzodiazepines has been recommended for reducing the risk of delirium in critically ill individuals. It is unclear if the medication

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Only a handful of studies exist where there has been an attempt to correlate delirium with pathological findings at autopsy. One research study has been reported on 7 people who died during ICU admission. Each case was admitted with a range of primary pathologies, but all had

336:, although delirium affects only 1–2% of the overall population, 18–35% of adults presenting to the hospital will have delirium, and delirium will occur in 29–65% of people who are hospitalized. Delirium occurs in 11–51% of older adults after surgery, in 81% of those in the 1557:

In the US, the cost of a hospital admission for people with delirium is estimated at between $ 16k and $ 64k, suggesting the national burden of delirium may range from $ 38 bn to $ 150 bn per year (2008 estimate). In the UK, the cost is estimated as £13k per admission.

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Rollo, Eleonora; Callea, Antonio; Brunetti, Valerio; Vollono, Catello; Marotta, Jessica; Imperatori, Claudio; Frisullo, Giovanni; Broccolini, Aldobrando; Della Marca, Giacomo (10 February 2021). "Delirium in acute stroke: A prospective, cross-sectional, cohort study".

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and low oxygen levels, and the sedative and pain medicines that are nearly universally given to all ICU patients. Outside the ICU, on hospital wards and in nursing homes, the problem of delirium is also a very important medical problem, especially for older patients.

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interdisciplinary team of health care professionals is suggested for people in the hospital at risk of delirium, and there is some evidence that this may decrease to incidence of delirium by up to 43% and may reduce the length of time that the person is hospitalized.

4789:"2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility" 3980:

Penfold, Rose S.; Squires, Charlotte; Angus, Alisa; Shenkin, Susan D.; Ibitoye, Temi; Tieges, Zoë; Neufeld, Karin J.; Avelino-Silva, Thiago J.; Davis, Daniel; Anand, Atul; Duckworth, Andrew D.; Guthrie, Bruce; MacLullich, Alasdair M. J. (2024-01-19).

1210:, or other dissociative conditions, can present with features similar to that of delirium. Such condition, however, would not qualify for a diagnosis of delirium per DSM-5-TR criterion D (i.e., fluctuating cognitive symptoms occurring as part of a 1438:

is not suggested. For adults with delirium who are near the end of their life (on palliative care) high quality evidence to support or refute the use of most medications to treat delirium is not available. Low quality evidence indicates that the

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Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825-e873.

4031: 1179:), requires chronic impairment (versus acute onset in delirium), and is typically not associated with changes in level of consciousness. Dementia is different from delirium in that dementia lasts long-term while delirium lasts short-term. 1102:

completion rates and tool positive score rates. Some tools, even if completed at high rates, showed delirium positive score rates that there much lower than the expected delirium occurrence level, suggesting low sensitivity in practice.

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Burton, Jennifer K.; Craig, Louise; Yong, Shun Qi; Siddiqi, Najma; Teale, Elizabeth A.; Woodhouse, Rebecca; Barugh, Amanda J.; Shepherd, Alison M.; Brunton, Alan; Freeman, Suzanne C.; Sutton, Alex J.; Quinn, Terry J. (2021-11-26).

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or age-associated cognitive impairment is the primary predisposing factor for clinical delirium and "prior pathology" as defined by these new animal models may consist of synaptic loss, abnormal network connectivity, and "primed

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Bellelli G, Nobili A, Annoni G, Morandi A, Djade CD, Meagher DJ, et al. (November 2015). "Under-detection of delirium and impact of neurocognitive deficits on in-hospital mortality among acute geriatric and medical wards".

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Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA (July 2010). "Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis".

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psychosis have intact cognitive function; however, primary psychosis can mimic delirium when it presents with disorganized thoughts and mood dysregulation. This is particularly true in the condition known as delirious

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These interventions are the first steps in managing acute delirium, and there are many overlaps with delirium preventative strategies. In addition to treating immediate life-threatening causes of delirium (e.g., low

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Nitchingham, Anita; Kumar, Varun; Shenkin, Susan; Ferguson, Karen J.; Caplan, Gideon A. (2018). "A systematic review of neuroimaging in delirium: predictors, correlates and consequences: Neuroimaging in delirium".

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Zachary, W.; Kirupananthan, A.; Cotter, S.; Barbara, G. H.; Cooke, RC III; Sipho, M. (2020). "The impact of Hospital Elder Life Program interventions, on 30-day readmission Rates of older hospitalized patients".

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Recent long-term studies showed that many people still meet criteria for delirium for a prolonged period after hospital discharge, with up to 21% of people showing persistent delirium at 6 months post-discharge.

218:, delirium presents with disturbances in attention, awareness, and higher-order cognition. People with delirium may experience other neuropsychiatric disturbances, including changes in psychomotor activity (e.g. 7352: 7337: 469:

are retained without need of concentration, so previously formed long-term memories (i.e., those formed before the onset of delirium) are usually preserved in all but the most severe cases of delirium, though

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Franco JG, Trzepacz PT, Sepúlveda E, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, et al. (2020). "Delirium diagnostic tool-provisional (DDT-Pro) scores in delirium, subsyndromal delirium and no delirium".

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Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. (January 2002). "Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult".

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years. The societal implications can be enormous when considering work-force issues related to the inability of wage-earners to work due to their own ICU stay or that of someone else they must care for.

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Tieges, Zoë; Maclullich, Alasdair M. J.; Anand, Atul; Brookes, Claire; Cassarino, Marica; O'connor, Margaret; Ryan, Damien; Saller, Thomas; Arora, Rakesh C.; Chang, Yue; Agarwal, Kathryn (2020-11-11).

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E. There is evidence that the disturbances above are a "direct physiological consequence" of another medical condition, substance intoxication or withdrawal, toxin, or various combinations of causes

929:, have produced similar effects. Along with clinical studies using various drugs with anticholinergic activity, these models have contributed to a "cholinergic deficiency hypothesis" of delirium. 2938:

Saini, Aman; Oh, Tae Hyun; Ghanem, Dory Anthony; Castro, Megan; Butler, Matthew; Sin Fai Lam, Chun Chiang; Posporelis, Sotiris; Lewis, Glyn; David, Anthony S.; Rogers, Jonathan P. (2021-10-15).

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Most often, delirium is reversible; however, people with delirium require treatment for the underlying cause(s) and often to prevent injury and other poor outcomes directly related to delirium.

273:), or from multiple factors affecting one's overall health (e.g., malnutrition, pain, etc.). In contrast, the emotional and behavioral features due to primary psychiatric disorders (e.g., as in 4032:"Trends in delirium coding rates in older hospital inpatients in England and Scotland: full population data comprising 7.7M patients per year show substantial increases between 2012 and 2020" 480:

A person may be disoriented to self, place, or time. Additionally, a person may be 'disoriented to situation' and not recognize their environment or appreciate what is going on around them.

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Soiza, Roy L.; Sharma, Vijay; Ferguson, Karen; Shenkin, Susan D.; Seymour, David Gwyn; MacLullich, Alasdair M.J. (September 2008). "Neuroimaging studies of delirium: A systematic review".

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required more assistance with their care needs) than those not experiencing infection. After an episode of delirium in the general population, functional dependence increased threefold.

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Slooter A, Otte WM, Devlin JW, Arora RC, Bleck TP, Claassen J, Duprey MS, Ely EW, Kaplan PW, Latronico N, Morandi A, Neufeld KJ, Sharshar T, MacLullich A, Stevens RD (February 2020).

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Voyer P, Richard S, Doucet L, Carmichael PH (March 2009). "Detecting delirium and subsyndromal delirium using different diagnostic criteria among demented long-term care residents".

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Burry, Lisa; Hutton, Brian; Williamson, David R.; Mehta, Sangeeta; Adhikari, Neill Kj; Cheng, Wei; Ely, E. Wesley; Egerod, Ingrid; Fergusson, Dean A.; Rose, Louise (September 2019).

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Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI (December 1990). "Clarifying confusion: the confusion assessment method. A new method for detection of delirium".

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than in schizophrenia or Alzheimer's disease. They usually relate to persecutory themes of impending danger or threat in the immediate environment (e.g., being poisoned by nurses).

6323:"Positive scores on the 4AT delirium assessment tool at hospital admission are linked to mortality, length of stay and home time: two-centre study of 82,770 emergency admissions" 3767:

Morandi A, Grossi E, Lucchi E, Zambon A, Faraci B, Severgnini J, et al. (July 2021). "The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia".

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The use of medications for delirium is generally restricted to managing its distressing or dangerous neuropsychiatric disturbances. Short-term use (one week or less) of low-dose

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A. Disturbance in attention and awareness. This is a required symptom and involves easy distraction, inability to maintain attentional focus, and varying levels of alertness.

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and more, is delirium caused by these kind of substances with Anticholinergic properties, unrelated to the type of Delirium which occurs in older people at age 65 and above.

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treatment. There is also moderate to low quality evidence to suggest that haloperidol and risperidone may be associated with a slight increase in side effects, specifically

1072:(MMSE) scores from 987 brain donors found that delirium combined with a pathological process of dementia accelerated MMSE score decline more than either individual process. 340:, and in 20–22% of individuals in nursing homes or post-acute care settings. Among those requiring critical care, delirium is a risk factor for death within the next year. 3983:"Delirium detection tools show varying completion rates and positive score rates when used at scale in routine practice in general hospital settings: A systematic review" 3259:

Tigchelaar, Celien; Atmosoerodjo, Sawal D.; van Faassen, Martijn; Wardenaar, Klaas J.; De Deyn, Peter P.; Schoevers, Robert A.; Kema, Ido P.; Absalom, Anthony R. (2021).

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Wilson, Jo Ellen; Mart, Matthew F.; Cunningham, Colm; Shehabi, Yahya; Girard, Timothy D.; MacLullich, Alasdair M. J.; Slooter, Arjen J. C.; Ely, E. Wesley (2020-11-12).

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Flannery AH, Oyler DR, Weinhouse GL (December 2016). "The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework".

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de Rooij SE, Schuurmans MJ, van der Mast RC, Levi M (July 2005). "Clinical subtypes of delirium and their relevance for daily clinical practice: a systematic review".

1093:. This is especially important for treating people who have neurocognitive or neurodevelopmental disorders, whose baseline mental status may be mistaken as delirium. 5169: 909:

The lack of animal models that are relevant to delirium has left many key questions in delirium pathophysiology unanswered. Earliest rodent models of delirium used

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Ibitoye, Temi; So, Sabrina; Shenkin, Susan D.; Anand, Atul; Reed, Matthew J.; Vardy, Emma R. L. C.; Pendelbury, Sarah T.; MacLullich, Alasdair M. J. (2023-05-15).

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Delirium may be difficult to diagnose without first establishing a person's usual mental function or 'cognitive baseline'. Delirium can be confused with multiple

6748: 6665: 308:, etc. Delirium may occur in persons with existing mental illness, baseline intellectual disability, or dementia, entirely unrelated to any of these conditions. 4173:"Diagnosing Delirium in Older Emergency Department Patients: Validity and Reliability of the Delirium Triage Screen and the Brief Confusional Assessment Method" 3937:

McCoy TH, Snapper L, Stern TA, Perlis RH (2016). "Underreporting of Delirium in Statewide Claims Data: Implications for Clinical Care and Predictive Modeling".

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McCusker J, Cole M, Abrahamowicz M, Han L, Podoba JE, Ramman-Haddad L (October 2001). "Environmental risk factors for delirium in hospitalized older people".

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Benzodiazepines can cause or worsen delirium, and there is no reliable evidence of efficacy for treating non-anxiety-related delirium. Similarly, people with

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are typically used as a treatment. There is evidence that the risk of delirium in hospitalized people can be reduced by non-pharmacological care bundles (see

383: 2477:"Predisposing and precipitating factors for delirium in community-dwelling older adults admitted to hospital with this condition: A prospective case series" 214:

consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days. As a

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Ludolph, Paul; Stoffers-Winterling, Jutta; Kunzler, Angela M.; Rösch, Romina; Geschke, Katharina; Vahl, Christian Friedrich; Lieb, Klaus (August 2020).

4459:"Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) with medical inpatients and comparison with the Confusion Assessment Method Algorithm" 3921: 1256:

therapeutic environment (e.g., individualized care, clear communication, adequate reorientation and lighting during daytime, promoting uninterrupted

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activity) than age-matched controls; this supports a neuroinflammatory cause to delirium, but the conclusions are limited by methodological issues.

5756:"Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery" 4743:

Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y (May 2001). "Intensive Care Delirium Screening Checklist: evaluation of a new screening tool".

4691:"Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU)" 5302:"Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature" 4220:

Schuurmans MJ, Shortridge-Baggett LM, Duursma SA (2003-01-01). "The Delirium Observation Screening Scale: a screening instrument for delirium".

5900: 1156:

There are conditions that might have similar clinical presentations to those seen in delirium. These include dementia, depression, psychosis,

5044: 2637:

Hughes CG, Patel MB, Pandharipande PP (October 2012). "Pathophysiology of acute brain dysfunction: what's the cause of all this confusion?".

1397:) is emerging, with the benefit for fewer side effects Use antipsychotic drugs with caution or not at all for people with conditions such as 1329:

Optimize physiology and conditions for brain recovery (e.g., oxygenation, hydration, nutrition, electrolytes, metabolites, medication review)

390:, the core features are broadly the same. In 2022, the American Psychiatric Association released the fifth edition text revision of the DSM ( 1908:

Siddiqi, Najma; Harrison, Jennifer K.; Clegg, Andrew; Teale, Elizabeth A.; Young, John; Taylor, James; Simpkins, Samantha A. (2016-03-11).

6159:

Finucane, Anne M.; Jones, Louise; Leurent, Baptiste; Sampson, Elizabeth L.; Stone, Patrick; Tookman, Adrian; Candy, Bridget (2020-01-21).

1464:

large (N=82,770) two-centre study in unselected older emergency population found that delirium detected as part of normal care using the

8404: 8360: 7463: 6690:

Roberson, Shawniqua Williams; Patel, Mayur B.; Dabrowski, Wojciech; Ely, E. Wesley; Pakulski, Cezary; Kotfis, Katarzyna (2021-09-14).

6097:

Roberson, Shawniqua Williams; Patel, Mayur B.; Dabrowski, Wojciech; Ely, E. Wesley; Pakulski, Cezary; Kotfis, Katarzyna (2021-09-14).

4414:

Kean J, Trzepacz PT, Murray LL, Abell M, Trexler L (2010). "Initial validation of a brief provisional diagnostic scale for delirium".

230:, emotional disturbances, disturbances of consciousness, or, altered state of consciousness, as well as perceptual disturbances (e.g. 7067: 3204:"Cerebrospinal Fluid and Spinal Anesthesia Parameters in Healthy Individuals versus Opium-addict Patients during Lower Limb Surgery" 2183: 401:

B. Onset is acute (from hours to days), representing a change from baseline mentation and often with fluctuations throughout the day

8219: 7836: 7649: 1420:

may have significant side effects with antipsychotics, and should either be treated with a none or small doses of benzodiazepines.

1207: 1427:

is occasionally used in the treatment of delirium, but it carries a risk of over-sedation, and its use has not been well studied.

7629: 1967:"Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis" 1468:

tool was strongly linked to 30-day mortality, hospital length of stay, and days at home in the year following the 4AT test date.

1295:-based total intravenous anaesthesia (TIVA) or with inhalational agents can affect the incidence rate of postoperative delirium. 985:

provides an important avenue to explore the mechanisms that are responsible for delirium. Despite progress in the development of

1167:: This group of disorders is acquired (non-congenital) with usually irreversible cognitive and psychosocial functional decline. 946:" brain macrophages stimulated by prior neurodegenerative disease and aging to amplify subsequent inflammatory responses in the 257:

the brain that nonetheless affects the brain. Delirium may be the result of an underlying medical condition (e.g., infection or

7955: 5529:"Social inequalities in the burden of care: A dyadic analysis in the caregiving partners of persons with a physical disability" 4171:

Han JH, Wilson A, Vasilevskis EE, Shinani A, Schnelle JF, Dittus RS, Graves AJ, Storrow AB, Shuster J, Ely EW (November 2013).

8731: 7266: 7097: 6917:

McCoy TH, Hart KL, Perlis RH (May 2017). "Characterizing and predicting rates of delirium across general hospital settings".

5989: 5163: 3368: 4657: 3720:"Association of Delirium With Cognitive Decline in Late Life: A Neuropathologic Study of 3 Population-Based Cohort Studies" 1535:. Sims (1995, p. 31) points out a "superb detailed and lengthy description" of delirium in "The Stroller's Tale" from 1189:

and delirium (especially the hypoactive subtype). Gathering a history from other caregivers can clarify baseline mentation.

1061:(markers of microglial activation), IL-6 (cytokines pro-inflammatory and anti-inflammatory activities) and GFAP (marker of 3145:

Ormseth, Cora H.; LaHue, Sara C.; Oldham, Mark A.; Josephson, S. Andrew; Whitaker, Evans; Douglas, Vanja C. (2023-01-06).

1768: 8416: 7564: 1042: 6856: 3389:

Cerejeira J, Firmino H, Vaz-Serra A, Mukaetova-Ladinska EB (June 2010). "The neuroinflammatory hypothesis of delirium".

2775: 602:

describes instances of delirium where activity level is either normal or fluctuating between hyperactive and hypoactive.

7666: 7641: 7476: 7304: 7285: 6692:"Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice" 6099:"Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice" 5806:

Woodhouse, Rebecca; Burton, Jennifer K; Rana, Namrata; Pang, Yan Ling; Lister, Jennie E; Siddiqi, Najma (2019-04-23).

1851: 1291:

in five studies (321 participants). The authors of this review were uncertain whether maintenance of anaesthesia with

688: 8452: 8272: 8170: 6073: 5876: 5730: 4921:"The Scottish Intercollegiate Guidelines Network (SIGN) 157: Guidelines on Risk Reduction and Management of Delirium" 4265:"Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale" 2413: 2224: 1443:

risperidone or haloperidol may make the delirium slightly worse in people who are terminally ill, when compared to a

1069: 914: 379:, however, the core features of delirium include an acute disturbance in attention, awareness, and global cognition. 3833: 3098:"At the extreme end of the psychoneuroimmunological spectrum: delirium as a maladaptive sickness behaviour response" 2940:"Inflammatory and blood gas markers of COVID-19 delirium compared to non-COVID-19 delirium: a cross-sectional study" 572:

can manifest in delirium (e.g., rapid changes between terror, sadness, joking, happiness, fear). This also includes

8726: 8544: 7781: 7752: 7693: 7214:"Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards" 1549:

noted in 1583 that if delirium (or "frensy") resolves, it may be followed by a loss of memory and reasoning power.

1545:. Historically, delirium has also been noted for its cognitive sequelae. For instance, the English medical writer 7786: 7581: 7506: 1049:

contributing to the delirium, 6 showed evidence of low brain perfusion and diffuse vascular injury, and 5 showed

443:

is required for delirium diagnosis. This may present as an impaired ability to direct, focus, sustain, or shift

210:, an ambiguous term which is now discouraged) is a specific state of acute confusion attributable to the direct 8439: 8224: 8195: 7456: 3856:"Delirium is under-reported in discharge summaries and in hospital administrative systems: a systematic review" 2166:"The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" 1725: 4887: 7965: 7683: 7659: 3347: 1116:(CAM), including variants such as the 3-Minute Diagnostic Interview for the CAM (3D-CAM) and brief CAM (bCAM) 596:

symptoms include decreased alertness, sparse or slow speech, lethargy, slowed movements, staring, and apathy.

495: 6432:"Association between acute care and critical illness hospitalization and cognitive function in older adults" 5871:. Scottish Intercollegiate Guidelines Network., Scotland. Healthcare Improvement Scotland. Edinburgh. 2019. 4357:"Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis" 3261:"The Anaesthetic Biobank of Cerebrospinal fluid: a unique repository for neuroscientific biomarker research" 1326:

Addressing any other possible predisposing and precipitating factors that might be disrupting brain function

8721: 8628: 8165: 7698: 7543: 1489: 17: 3622:"Brain autopsy findings in intensive care unit patients previously suffering from delirium: a pilot study" 7873: 7671: 6779: 5754:

Miller D, Lewis SR, Pritchard MW, Schofield-Robinson OJ, Shelton CL, Alderson P, Smith AF (August 2018).

3202:

Derakhshan, Pooya; Imani, Farnad; Seyed-Siamdoust, Seyed Alireza; Garousi, Sorour; Nouri, Nasrin (2020).

1113: 693: 8686: 2475:

Magny E, Le Petitcorps H, Pociumban M, Bouksani-Kacher Z, Pautas É, Belmin J, et al. (2018-02-23).

8623: 7538: 5904: 986: 6321:

Anand, Atul; Cheng, Michael; Ibitoye, Temi; Maclullich, Alasdair M J; Vardy, Emma R L C (2022-03-01).

5974:

The American Psychiatric Association Publishing Textbook of Neuropsychiatry and Clinical Neurosciences

1451:

symptoms, if the person near the end of their life has delirium that is mild to moderate in severity.

8633: 8602: 7980: 7863: 7449: 6618:

Hopkins RO, Jackson JC (September 2006). "Long-term neurocognitive function after critical illness".

3536:

Shafi MM, Santarnecchi E, Fong TG, Jones RN, Marcantonio ER, Pascual-Leone A, Inouye SK (June 2017).

3321:

Hall RJ, Watne LO, Cunningham E, Zetterberg H, Shenkin SD, Wyller TB, MacLullich AM (November 2018).

2174: 2122:"Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit" 1430:

For adults with delirium that are in the ICU, medications are used commonly to improve the symptoms.

1417: 1402: 1275: 1221:

disorders (e.g., infections, hypoxia, etc.) can precipitate delirium as a mental side-effect/symptom.

917:

blocker) to induce cognitive and electroencephalography (EEG) changes similar to delirium, and other

782: 490:

is usually noticed with speech that makes limited sense with apparent irrelevancies, and can involve

31: 6272:

Davis DH, Muniz Terrera G, Keage H, Rahkonen T, Oinas M, Matthews FE, et al. (September 2012).

8681: 8597: 8592: 8289: 8252: 8244: 8062: 8031: 7772: 7757: 7367: 4304:

Voyer P, Champoux N, Desrosiers J, Landreville P, McCusker J, Monette J, et al. (2015-01-01).

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Santos C.D., Rose M.Q. Extrapyramidal symptoms induced by treatment for delirium: A case report.

1440: 6274:"Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study" 1525:

Delirium is one of the oldest forms of mental disorder known in medical history. The Roman author

1344:

Provide adequate follow-up including consideration of possible dementia and post-traumatic stress.

432:, the syndrome of delirium encompasses a broad range of additional neuropsychiatric disturbances. 411:

D. The disturbances (criteria A and C) are not better explained by another neurocognitive disorder

8618: 8125: 7975: 7970: 7927: 7744: 4122:

Marcantonio ER, Ngo LH, O'Connor M, Jones RN, Crane PK, Metzger ED, Inouye SK (21 October 2014).

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Berrios GE (November 1981). "Delirium and confusion in the 19th century: a conceptual history".

6579:"Persistent delirium in older hospital patients: a systematic review of frequency and prognosis" 4457:

Franco JG, Ocampo MV, Velásquez-Tirado JD, Zaraza DR, Giraldo AM, Serna PA, et al. (2020).

8496: 8135: 8026: 7985: 7960: 7868: 6430:

Ehlenbach WJ, Hough CL, Crane PK, Haneuse SJ, Carson SS, Curtis JR, Larson EB (February 2010).

4124:"3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium" 3718:

Davis DH, Muniz-Terrera G, Keage HA, Stephan BC, Fleming J, Ince PG, et al. (March 2017).

1526: 1398: 1382: 1381:

is among the more common pharmacological approaches to delirium. Evidence for effectiveness of

1021: 997:, which are known to be associated with overlapping changes in the brain also observed on MRI. 947: 772: 613:

Delirium arises through the interaction of a number of predisposing and precipitating factors.

289: 242: 172: 7407: 8691: 8424: 8304: 8211: 8190: 5153: 5136: 3669:

Munster BC, Aronica E, Zwinderman AH, Eikelenboom P, Cunningham C, Rooij SE (December 2011).

850: 372: 285: 241:

Diagnostically, delirium encompasses both the syndrome of acute confusion and its underlying

219: 157: 77: 6801:

Ryan DJ, O'Regan NA, Caoimh RÓ, Clare J, O'Connor M, Leonard M, et al. (January 2013).

5670:

Gosch M, Nicholas JA (February 2014). "Pharmacologic prevention of postoperative delirium".

5245:"Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients" 2014:

Burry L, Mehta S, Perreault MM, Luxenberg JS, Siddiqi N, Hutton B, et al. (June 2018).

1341:

Communicate effectively with the person experiencing delirium and their carers or caregivers

524:, and word-finding difficulties all involve impairment of linguistic information processing. 8516: 8429: 8185: 8005: 7606: 7586: 6878:"Occurrence and outcome of delirium in medical in-patients: a systematic literature review" 6380:"Long-term cognitive impairment and functional disability among survivors of severe sepsis" 5480:"Non-Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People" 4030:

Ibitoye, Temi; Jackson, Thomas A.; Davis, Daniel; MacLullich, Alasdair M. J. (2023-07-29).

2488: 1053:

involvement. A case-control study showed that 9 delirium cases showed higher expression of

864: 405: 5981: 4987:

Oh, Esther S.; Fong, Tamara G.; Hshieh, Tammy T.; Inouye, Sharon K. (September 26, 2017).

2165: 1004:

integrity (white matter lesions), decreases in brain volume (likely as a result of tissue

901:

The pathophysiology of delirium is still not well understood, despite extensive research.

8: 8566: 8548: 8511: 8501: 8355: 8257: 8234: 8082: 8074: 7853: 7831: 7559: 7356: 7031: 5527:

Tough, H.; Brinkhof, M. W.; Siegrist, J.; Fekete, C.; for the SwiSCI Study Group (2019).

1541: 1186: 969:

showed that, broadly, delirium may be associated with neurotransmitter imbalance (namely

959: 846: 376: 337: 7141:. London: By Thomas Vautroullier dwelling in the Blacke-friars by Lud-gate. p. 18. 6858:

National Guidelines for Seniors' Mental Health: The Assessment and Treatment of Delirium

4689:

Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. (December 2001).

4306:"Recognizing acute delirium as part of your routine [RADAR]: a validation study" 3585:

Engel GL, Romano J (Fall 2004). "Delirium, a syndrome of cerebral insufficiency. 1959".

2492: 1942: 1909: 8229: 7826: 7678: 7361: 7189: 7164: 7059: 7012: 6930: 6827: 6802: 6724: 6691: 6643: 6554: 6529: 6505: 6480: 6456: 6431: 6404: 6379: 6355: 6322: 6298: 6273: 6249: 6193: 6160: 6131: 6098: 6041: 6016: 5995: 5944: 5919: 5894: 5840: 5808:"Interventions for preventing delirium in older people in institutional long-term care" 5780: 5755: 5722: 5695: 5652: 5604: 5579: 5555: 5528: 5460: 5411: 5394: 5367: 5342: 5277: 5244: 5216: 5191: 5114: 5079: 5021: 4988: 4955: 4920: 4869: 4826: 4768: 4632: 4583: 4550: 4524: 4512: 4439: 4391: 4356: 4332: 4305: 4245: 4197: 4172: 4148: 4123: 4104: 4056: 3962: 3792: 3744: 3719: 3695: 3670: 3646: 3621: 3562: 3537: 3475: 3424: 3360: 3295: 3260: 3236: 3203: 3179: 3162: 3122: 3097: 3070: 3045: 3021: 2996: 2977: 2915: 2898: 2882: 2822: 2767: 2705: 2662: 2614: 2589: 2565: 2556: 2540: 2511: 2476: 2457: 2387: 2344: 2099: 2040: 1991: 1966: 1817: 1792: 1682: 1669: 1634: 1603: 1579:"Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies" 1578: 1283: 1090: 1009: 569: 72: 6803:"Delirium in an adult acute hospital population: predictors, prevalence and detection" 6707: 6114: 5207: 4551:"Pharmacological interventions for the treatment of delirium in critically ill adults" 4281: 4264: 4188: 3147:"Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review" 2739: 2541:"Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review" 1319:

Treatment of delirium requires attention to multiple domains including the following:

1278:, reduces delirium following surgery. There is also no clear evidence to suggest that 8475: 8000: 7990: 7922: 7848: 7732: 7378: 7300: 7281: 7262: 7235: 7194: 7117: 7093: 7051: 7016: 7004: 6969: 6934: 6899: 6832: 6729: 6711: 6635: 6600: 6559: 6528:

Fong TG, Jones RN, Shi P, Marcantonio ER, Yap L, Rudolph JL, et al. (May 2009).

6510: 6461: 6409: 6360: 6342: 6303: 6241: 6198: 6180: 6136: 6118: 6079: 6069: 6046: 5999: 5985: 5949: 5882: 5872: 5845: 5827: 5785: 5736: 5726: 5687: 5644: 5609: 5578:

Poongkunran C, John SG, Kannan AS, Shetty S, Bime C, Parthasarathy S (October 2015).

5560: 5509: 5501: 5464: 5452: 5416: 5372: 5323: 5282: 5264: 5221: 5159: 5119: 5101: 5026: 5008: 4960: 4942: 4861: 4830: 4818: 4810: 4760: 4722: 4624: 4620: 4588: 4570: 4528: 4516: 4480: 4475: 4458: 4431: 4396: 4378: 4337: 4286: 4249: 4237: 4202: 4153: 4096: 4061: 4012: 4004: 3954: 3899: 3796: 3784: 3749: 3735: 3700: 3651: 3602: 3598: 3567: 3513: 3509: 3467: 3428: 3416: 3364: 3352: 3300: 3282: 3241: 3223: 3184: 3166: 3146: 3127: 3075: 3026: 2981: 2969: 2961: 2920: 2902: 2863: 2826: 2814: 2759: 2697: 2693: 2654: 2619: 2570: 2516: 2449: 2409: 2379: 2336: 2301: 2266: 2262: 2230: 2220: 2143: 2117: 2091: 2087: 2045: 1996: 1947: 1929: 1822: 1808: 1793:"Pseudodelirium: Psychiatric Conditions to Consider on the Differential for Delirium" 1760: 1686: 1674: 1656: 1608: 1172: 994: 966: 880: 827: 658: 503: 458: 454: 318: 258: 161: 48: 7441: 7063: 6481:"Cognitive decline after hospitalization in a community population of older persons" 6253: 5699: 5656: 5192:"Delirium and depression: inter-relationship and clinical overlap in elderly people" 4772: 4636: 4443: 3479: 3061: 2883:"Stratified delirium risk using prescription medication data in a state-wide cohort" 2709: 2666: 2539:

Ormseth CH, LaHue SC, Oldham MA, Josephson SA, Whitaker E, Douglas VC (2023-01-06).

2391: 2348: 2120:, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE, et al. (April 2004). 8345: 8299: 8267: 8115: 8093: 8058: 7821: 7703: 7654: 7601: 7576: 7571: 7528: 7516: 7418: 7225: 7184: 7176: 7043: 6996: 6961: 6926: 6889: 6822: 6814: 6719: 6703: 6647: 6627: 6590: 6549: 6541: 6500: 6492: 6451: 6443: 6399: 6391: 6350: 6334: 6293: 6285: 6233: 6188: 6176: 6172: 6126: 6110: 6036: 6028: 5977: 5939: 5931: 5920:"Review articles: postoperative delirium: acute change with long-term implications" 5835: 5823: 5819: 5775: 5771: 5767: 5718: 5713:

Slooter AJ, Van De Leur RR, Zaal IJ (2017). "Delirium in critically ill patients".

5679: 5636: 5599: 5591: 5550: 5540: 5491: 5444: 5406: 5362: 5354: 5343:"Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness" 5313: 5272: 5260: 5256: 5211: 5203: 5109: 5091: 5016: 5000: 4950: 4932: 4853: 4800: 4752: 4712: 4702: 4616: 4578: 4566: 4562: 4508: 4470: 4423: 4386: 4368: 4327: 4317: 4276: 4229: 4192: 4184: 4143: 4135: 4108: 4088: 4051: 4043: 3994: 3966: 3946: 3891: 3863: 3776: 3739: 3731: 3690: 3682: 3641: 3633: 3594: 3557: 3549: 3505: 3459: 3406: 3398: 3342: 3334: 3290: 3272: 3231: 3215: 3174: 3158: 3117: 3109: 3065: 3057: 3016: 3008: 2951: 2910: 2894: 2853: 2806: 2751: 2689: 2646: 2609: 2601: 2560: 2552: 2506: 2496: 2461: 2441: 2371: 2362:

Meagher D (February 2009). "Motor subtypes of delirium: past, present and future".

2328: 2293: 2258: 2214: 2161: 2133: 2083: 2035: 2031: 2027: 1986: 1978: 1937: 1925: 1921: 1812: 1804: 1664: 1646: 1598: 1590: 1529:

used the term to describe mental disturbance from head trauma or fever in his work

1239: 743: 697: 487: 466: 278: 227: 109: 8474: 5448: 4873: 2956: 2939: 2881:

McCoy, Thomas H.; Castro, Victor M.; Hart, Kamber L.; Perlis, Roy H. (July 2021).

2771: 2432:

Liptzin B, Levkoff SE (December 1992). "An empirical study of delirium subtypes".

30:

This article is about the mental state and medical condition. For other uses, see

8521: 8479: 8350: 8337: 8284: 8279: 8262: 8142: 7937: 7909: 7710: 7533: 7472: 7372: 7180: 6854: 6545: 6496: 5935: 5807: 5640: 5595: 5140: 4857: 4805: 4788: 4427: 4092: 3925: 2650: 2501: 2103: 1536: 1431: 1304:

risk factors and care homes' solutions for reducing delirium is still uncertain.

1148:

person without any likely interventions to help reduce the duration of delirium.

1029: 918: 868: 471: 348: 344: 321: 101: 8571: 6965: 6818: 3780: 2997:"Cholinergic deficiency hypothesis in delirium: a synthesis of current evidence" 2297: 8506: 8447: 8371: 8180: 8147: 8130: 8120: 7383: 7165:"One-year health care costs associated with delirium in the elderly population" 5358: 4233: 3950: 3895: 3826:"Delirium: Prevention, diagnosis and management in hospital and long-term care" 3637: 3001:

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

2842:"Which medications to avoid in people at risk of delirium: a systematic review" 2198: 2179: 1748: 1651: 1594: 1410: 974:

evidence is still conflicting and fails to concretely support this hypothesis.

767:

Severe drop in blood pressure, relative to the person's normal blood pressure (

735: 513: 356: 325: 313: 266: 246: 89: 5886: 5869:

Risk reduction and management of delirium : a national clinical guideline

5683: 5545: 4322: 3620:

Janz DR, Abel TW, Jackson JC, Gunther ML, Heckers S, Ely EW (September 2010).

3402: 3113: 3012: 2375: 1134:

Delirium Diagnostic Tool-Provisional (DDT-Pro), also for subsyndromal delirium

1000:

Evidence for changes in structural and functional markers include: changes in

8715: 8540: 8491: 7809: 7163:

Leslie DL, Marcantonio ER, Zhang Y, Leo-Summers L, Inouye SK (January 2008).

7047: 6862: 6715: 6479:

Wilson RS, Hebert LE, Scherr PA, Dong X, Leurgens SE, Evans DA (March 2012).

6346: 6338: 6184: 6122: 6083: 5831: 5505: 5268: 5105: 5096: 5012: 4946: 4937: 4888:"Treating Delirium & Agitation in the Emergency Room, 2015 | EB Medicine" 4814: 4707: 4690: 4574: 4382: 4373: 4008: 3286: 3227: 3170: 2965: 2906: 2605: 2234: 2138: 2121: 1933: 1660: 1546: 1434:

may shorten the length of the delirium in adults who are critically ill, and

1406: 1287: 1257: 854: 677: 643: 559: 499: 382:

Although slight differences exist between the definitions of delirium in the

301: 274: 231: 211: 105: 7346: 7230: 7213: 6894: 6877: 6631: 6595: 6578: 6032: 5318: 5301: 5004: 3918: 2858: 2841: 711:

Environmental, psychophysiological stress (as found in acute care settings)

667:

Functional dependence (e.g., requiring assistance for self-care or mobility)

8394: 8175: 7727: 7239: 7198: 7055: 6973: 6938: 6903: 6836: 6733: 6639: 6604: 6563: 6514: 6465: 6413: 6395: 6364: 6307: 6289: 6245: 6237: 6202: 6140: 6050: 5953: 5849: 5789: 5740: 5691: 5648: 5613: 5564: 5513: 5456: 5420: 5376: 5341:

Hshieh, T. T.; Yang, T.; Gartaganis, S. L.; Yue, J.; Inouye, S. K. (2018).

5327: 5286: 5225: 5123: 5030: 4964: 4865: 4822: 4764: 4726: 4628: 4592: 4520: 4484: 4435: 4400: 4341: 4290: 4241: 4206: 4157: 4065: 4016: 3958: 3903: 3788: 3753: 3704: 3655: 3606: 3571: 3517: 3471: 3420: 3388: 3356: 3304: 3245: 3219: 3188: 3131: 3079: 3030: 2973: 2924: 2867: 2818: 2763: 2701: 2658: 2623: 2574: 2520: 2383: 2340: 2270: 2147: 2095: 2074:

Attard A, Ranjith G, Taylor D (August 2008). "Delirium and its treatment".

2049: 2016:"Antipsychotics for treatment of delirium in hospitalised non-ICU patients" 2000: 1951: 1843: 1826: 1764: 1678: 1612: 1435: 1332:

Detect and manage distress and behavioral disturbances (e.g., pain control)

1046: 1001: 982: 841: 821: 797: 751: 747: 671: 617:

change over time, thus an individual's risk of delirium is modifiable (see

7008: 7000: 6447: 5580:"A meta-analysis of sleep-promoting interventions during critical illness" 4756: 4100: 3686: 3258: 2474: 2453: 2445: 2305: 474:

of such information may be impaired due to global impairment in cognition.

8379: 8110: 7841: 7591: 7402: 3825: 3277: 2755: 1791:

Wilson JE, Andrews P, Ainsworth A, Roy K, Ely EW, Oldham MA (Fall 2021).

1531: 1495:

and continues to receive increasing attention in ongoing investigations.

1386: 1378: 1050: 831: 558:, which involve the misperception of real stimuli in the environment, or 360: 261:), side effect of a medication, substance intoxication (e.g., opioids or 148: 97: 27:

Severe confusion that develops quickly, and often fluctuates in intensity

4047: 3867: 1910:"Interventions for preventing delirium in hospitalised non-ICU patients" 8696: 8389: 8294: 7995: 7720: 7715: 7511: 7429: 7424: 4717: 3411: 3322: 1394: 1390: 1279: 1261:

and treatment is weak and insufficient to make proper recommendations.

1171:

usually results from an identifiable degenerative brain disease (e.g.,

793: 568:: Distortions to perceived or communicated emotional states as well as 545: 517: 352: 262: 192: 85: 65: 61: 7329: 5753: 5496: 5479: 5477: 3999: 3982: 3553: 2810: 2215:

Hales, Robert E.; Yudofsky, Stuart C.; Gabbard, Glen O., eds. (2008).

1982: 1206:: Some mental illnesses, such as a manic episode of bipolar disorder, 8649: 8581: 8399: 7858: 7596: 7521: 7413: 4658:"Critical Illness, Brain Dysfunction, and Survivorshpi (CIBS) Center" 4139: 3463: 3338: 3201: 2332: 1424: 1271: 1157: 1062: 970: 943: 922: 808: 590:(hyperactive sub-typing is defined with at least three of the above). 573: 541: 537: 462: 444: 440: 429: 305: 153: 93: 81: 57: 7090:

Symptoms in the mind: an introduction to descriptive psychopathology

5080:"Clinical Practice Guidelines for Management of Delirium in Elderly" 1965:

Neufeld KJ, Yue J, Robinson TN, Inouye SK, Needham DM (April 2016).

1717: 1338:

Provide rehabilitation through cognitive engagement and mobilization

8384: 8054: 7947: 5717:. Handbook of Clinical Neurology. Vol. 141. pp. 449–466. 4219: 3668: 1299:

Interventions for preventing delirium in long-term care or hospital

1292: 1168: 1081: 990: 938: 926: 910: 884: 812: 637: 555: 521: 391: 333: 297: 293: 270: 235: 215: 177: 6222: 4456: 4303: 2318: 7162: 6749:"When ICU Delirium Leads To Symptoms Of Dementia After Discharge" 6666:"When ICU Delirium Leads To Symptoms Of Dementia After Discharge" 5433: 4263:

Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA (April 2005).

2590:"Delirium in elderly adults: diagnosis, prevention and treatment" 2219:(5th ed.). Washington, DC: American Psychiatric Publishing. 1444: 1005: 540:

include suspiciousness, overvalued ideation and frank delusions.

424: 187:

Treating underlying cause, symptomatic management with medication

165: 7032:"A brief review of the history of delirium as a mental disorder" 6017:"Delirium in Older Persons: Advances in Diagnosis and Treatment" 4989:"Delirium in Older Persons: Advances in Diagnosis and Treatment" 3671:"Neuroinflammation in delirium: a postmortem case-control study" 1217:

disorder are results of the said mental disorder itself), while

8102: 7917: 7341: 6861:. Canadian Coalition for Seniors' Mental Health. Archived from 6271: 4121: 3448: 1509: 1054: 933: 835: 778: 739: 647: 491: 387: 7030:

Adamis D, Treloar A, Martin FC, Macdonald AJ (December 2007).

3717: 2160: 1323:

Identify and treat the underlying medical disorder or cause(s)

840:

Poor nutritional status, dehydration, electrolyte imbalances,

8539: 7880: 6775: 6530:"Delirium accelerates cognitive decline in Alzheimer disease" 4844:

Jones SF, Pisani MA (April 2012). "ICU delirium: an update".

4497: 4029: 3320: 2284:

Lipowski ZJ (March 1989). "Delirium in the elderly patient".

860: 404:

C. At least one additional cognitive disturbance (in memory,

7029: 6951: 4354: 3538:"Advancing the Neurophysiological Understanding of Delirium" 2013: 562:, which involve the perception of stimuli that do not exist. 8053: 6320: 6158: 5972:

DeWitt, Marie A.; Tune, Larry E. (2018-07-06), "Delirium",

5577: 5526: 5189: 4785: 4262: 4170: 3880: 3144: 2995:

Hshieh TT, Fong TG, Marcantonio ER, Inouye SK (July 2008).

2994: 2679: 2538: 2247: 1632: 1405:. Evidence for the effectiveness of medications (including 1058: 238:), although these features are not required for diagnosis. 6800: 6429: 4548: 4078: 3979: 3535: 3495: 3043: 2795: 2217:

The American Psychiatric Publishing textbook of psychiatry

1125:

Recognizing Acute Delirium As part of your Routine (RADAR)

892:

Major surgery (e.g. cardiac, orthopedic, vascular surgery)

7278:

Delirium: acute confusional states in palliative medicine

7256: 6689: 6096: 4463:

The Journal of Neuropsychiatry and Clinical Neurosciences

3766: 3587:

The Journal of Neuropsychiatry and Clinical Neurosciences

1907: 1790: 1465: 1128: 1068:

A 2017 retrospective study correlating autopsy data with

6378:

Iwashyna TJ, Ely EW, Smith DM, Langa KM (October 2010).

6066:

Cambridge Textbook of Effective Treatments in Psychiatry

4742: 4605: 2636: 2116: 1964: 461:

new information, largely as a result of having impaired

457:

that occurs in delirium is often due to an inability to

249:. The cause of delirium may be either a disease process 8326: 6527: 6015:

Oh ES, Fong TG, Hshieh TT, Inouye SK (September 2017).

5805: 5340: 4413: 3936: 1160:, and other conditions that affect cognitive function. 1109:

Examples of tools in use in clinical practice include:

6855:

Canadian Coalition for Seniors' Mental Health (2006).

6577:

Cole MG, Ciampi A, Belzile E, Zhong L (January 2009).

6576: 6478: 5712: 5626: 5241: 5045:"Making Sense of Delirium in the Emergency Department" 4688: 3619: 1576: 629:

Important predisposing factors include the following:

281:) do not meet the diagnostic criteria for 'delirium'. 7471: 6954:

Journal of the American Medical Directors Association

6377: 5190:

O'Sullivan R, Inouye SK, Meagher D (September 2014).

3853: 3769:

Journal of the American Medical Directors Association

3046:"Sepsis-associated encephalopathy: not just delirium" 2880: 1797:

Journal of Neuropsychiatry and Clinical Neurosciences

7319: 6161:"Drug therapy for delirium in terminally ill adults" 3095: 3044:

Zampieri FG, Park M, Machado FS, Azevedo LC (2011).

6776:"ICU Delirium and Cognitive Impairment Study Group" 2937: 2073: 771:) resulting in inadequate blood flow to the brain ( 371:In common usage, delirium can refer to drowsiness, 119:

Any age, but more often in people aged 65 and above

7489: 7299:. Hauppauge, N.Y.: Nova Science Publisher's, Inc. 6875: 6014: 5917: 4986: 3091: 3089: 2587: 7211: 5299: 3830:National Institute for Health and Care Excellence 3348:20.500.11820/5933392d-bf79-4b57-940f-8a5c51f3b02e 3323:"CSF biomarkers in delirium: a systematic review" 8713: 7898: 5078:Grover, Sandeep; Avasthi, Ajit (February 2018). 1786: 1784: 1782: 1780: 1778: 932:Profound systemic inflammation occurring during 408:, language, visuospatial ability, or perception) 156:, chronic health problems, certain medications, 135:Hyperactive, hypoactive, mixed level of activity 6916: 5976:, American Psychiatric Association Publishing, 5152:Mendez, Mario F.; Cummings, Jeffrey L. (2003). 4738: 4736: 3086: 704:common precipitating factors are listed below: 506:, and other signs of a formal thought disorder. 8671: 7275: 6617: 5151: 2588:Fong TG, Tulebaev SR, Inouye SK (April 2009). 2431: 2007: 7457: 6945: 6425: 6423: 5669: 5388: 5386: 5077: 3452:International Journal of Geriatric Psychiatry 3327:International Journal of Geriatric Psychiatry 3096:Cunningham C, Maclullich AM (February 2013). 2733: 2731: 2729: 2727: 2725: 2723: 2721: 2719: 2321:International Journal of Geriatric Psychiatry 1903: 1901: 1899: 1897: 1895: 1893: 1891: 1775: 1572: 1570: 664:Sensory impairment (i.e., vision and hearing) 394:) with the following criteria for diagnosis: 7294: 7257:Macdonald A, Lindesay J, Rockwood K (2002). 6876:Siddiqi N, House AO, Holmes JD (July 2006). 6850: 6848: 6846: 6767: 5706: 5347:The American Journal of Geriatric Psychiatry 4733: 4599: 2581: 2110: 1483: 1348: 6165:The Cochrane Database of Systematic Reviews 5760:The Cochrane Database of Systematic Reviews 5249:The Cochrane Database of Systematic Reviews 4843: 4555:The Cochrane Database of Systematic Reviews 3584: 2408:. Springfield, IL: Charles C Thomas. 1980. 2067: 2020:The Cochrane Database of Systematic Reviews 1914:The Cochrane Database of Systematic Reviews 8361:Other specified feeding or eating disorder 7628: 7464: 7450: 6420: 6218: 6216: 6214: 6212: 5971: 5899:: CS1 maint: location missing publisher ( 5672:Zeitschrift für Gerontologie und Geriatrie 5533:International Journal for Equity in Health 5484:Journal of the American Geriatrics Society 5383: 5300:Martinez F, Tobar C, Hill N (March 2015). 4918: 4684: 4682: 3987:Journal of the American Geriatrics Society 3542:Journal of the American Geriatrics Society 2839: 2833: 2716: 2682:Journal of the American Geriatrics Society 2534: 2532: 2530: 1971:Journal of the American Geriatrics Society 1888: 1712: 1710: 1708: 1706: 1704: 1702: 1700: 1698: 1696: 1628: 1626: 1624: 1622: 1567: 1122:Nursing Delirium Screening Scale (Nu-DESC) 1119:Delirium Observation Screening Scale (DOS) 877:Post-traumatic event (e.g. fall, fracture) 807:Infections – especially respiratory (e.g. 720:Urinary retention, use of bladder catheter 717:Immobilization, use of physical restraints 708:Prolonged sleep restriction or deprivation 7297:Delirium: causes, diagnosis and treatment 7229: 7188: 6893: 6843: 6826: 6723: 6594: 6553: 6504: 6455: 6403: 6354: 6297: 6267: 6265: 6263: 6192: 6130: 6063: 6040: 5943: 5839: 5779: 5603: 5554: 5544: 5495: 5410: 5366: 5317: 5276: 5215: 5113: 5095: 5020: 4954: 4936: 4804: 4716: 4706: 4582: 4474: 4390: 4372: 4331: 4321: 4280: 4196: 4147: 4055: 3998: 3919:https://doi.org/10.1186/s12888-016-0878-6 3743: 3694: 3645: 3561: 3410: 3346: 3294: 3276: 3235: 3178: 3121: 3069: 3020: 2955: 2914: 2857: 2613: 2564: 2510: 2500: 2249:Psychiatry and Psychosomatics (EACLPP)". 2137: 2039: 1990: 1941: 1816: 1668: 1650: 1602: 1151: 226:, or mixed level of activity), disrupted 8624:Disorganized (hebephrenic) schizophrenia 8220:Depersonalization-derealization disorder 7212:Akunne A, Murthy L, Young J (May 2012). 7129: 6778:. Vanderbilt University Medical Center. 4222:Research and Theory for Nursing Practice 2398: 2283: 1958: 1885:2021;41(3):50-54. doi:10.4037/ccn2021765 687: 683: 375:, disorientation, or hallucinations. In 6986: 6659: 6657: 6209: 5918:Rudolph JL, Marcantonio ER (May 2011). 5812:Cochrane Database of Systematic Reviews 4679: 3820: 3818: 3816: 3814: 3812: 3810: 3808: 3806: 2527: 2361: 1746: 1693: 1619: 1365:Another approached called the "T-A-DA ( 624: 14: 8714: 6746: 6663: 6260: 6154: 6152: 6150: 6068:. Leiden: Cambridge University Press. 5967: 5965: 5963: 5863: 5861: 5859: 5437:Archives of Gerontology and Geriatrics 5395:"The Demographic Faces of the Elderly" 5073: 5071: 5069: 4914: 4912: 4544: 4542: 4540: 4538: 4269:Journal of Pain and Symptom Management 2737: 1838: 1836: 1520: 1250: 1138: 1032:like those with Alzheimer's disease). 953: 874:Chronic/terminal illness (e.g. cancer) 292:because of many overlapping signs and 8670: 8538: 8473: 8325: 8052: 7897: 7807: 7627: 7488: 7445: 6010: 6008: 5982:10.1176/appi.books.9781615372423.sy08 5801: 5799: 5392: 5237: 5235: 4982: 4980: 4978: 4976: 4974: 4652: 4650: 4648: 4646: 3884:European Journal of Internal Medicine 3531: 3529: 3527: 3491: 3489: 3444: 3442: 3440: 3438: 3316: 3314: 2427: 2425: 2210: 2208: 544:are typically poorly formed and less 534:Psychotic and other erroneous beliefs 418: 7808: 7261:. Oxford : Oxford University Press. 7087: 6782:from the original on 10 October 2013 6747:Harris, Richard (October 10, 2018). 6664:Harris, Richard (October 10, 2018). 6654: 3803: 2406:Delirium: Acute Brian Failure in Man 759:Substance intoxication or withdrawal 343:Another type of Delirium, caused by 8327:Physiological and physical behavior 7295:Newman JK, Slater CT, eds. (2012). 7280:. Oxford: Oxford University Press. 6147: 5960: 5856: 5066: 4909: 4535: 2744:The New England Journal of Medicine 2286:The New England Journal of Medicine 1833: 1728:from the original on April 22, 2022 1460:co-morbidity or illness severity). 1367:tolerate, anticipate, don't agitate 1096: 1043:acute respiratory distress syndrome 726:Severe constipation/fecal impaction 24: 8273:Psychogenic non-epileptic seizures 7667:Emotional and behavioral disorders 7249: 6931:10.1016/j.genhosppsych.2017.01.006 6005: 5796: 5723:10.1016/B978-0-444-63599-0.00025-9 5232: 4971: 4643: 4513:10.1016/j.genhosppsych.2020.10.003 3524: 3486: 3435: 3311: 3163:10.1001/jamanetworkopen.2022.49950 2899:10.1016/j.genhosppsych.2021.05.001 2840:Clegg A, Young JB (January 2011). 2557:10.1001/jamanetworkopen.2022.49950 2422: 2364:International Review of Psychiatry 2205: 1264: 1016: 896: 692:Acute confusional state caused by 676:Substance use disorder, including 423:Delirium exists across a range of 25: 8743: 8453:Hypoactive sexual desire disorder 7315: 6989:The British Journal of Psychiatry 6708:10.2174/1570159X19666210119153839 6115:10.2174/1570159X19666210119153839 5399:Population and Development Review 4282:10.1016/j.jpainsymman.2004.07.009 4189:10.1016/j.annemergmed.2013.05.003 3498:Journal of Psychosomatic Research 2434:The British Journal of Psychiatry 2251:Journal of Psychosomatic Research 1185:: Similar symptoms exist between 1035: 915:muscarinic acetylcholine receptor 197:Depending on the underlying cause 7753:X-linked intellectual disability 7205: 7156: 7123: 7106: 7092:. Philadelphia: W. B. Saunders. 7081: 7023: 6980: 6910: 6869: 6794: 6740: 6683: 6611: 6570: 6521: 6472: 6371: 6314: 5584:The American Journal of Medicine 4846:Current Opinion in Critical Care 4793:Pediatric Critical Care Medicine 4621:10.1097/00003246-200201000-00020 4476:10.1176/appi.neuropsych.18110255 3736:10.1001/jamapsychiatry.2016.3423 3599:10.1176/appi.neuropsych.16.4.526 3510:10.1016/j.jpsychores.2008.05.021 3265:Annals of Translational Medicine 2694:10.1046/j.1532-5415.2001.49260.x 2639:Current Opinion in Critical Care 2263:10.1016/j.jpsychores.2012.05.009 2088:10.2165/00023210-200822080-00002 1872:doi:10.1097/CCM.0000000000003299 1809:10.1176/appi.neuropsych.20120316 1771:from the original on 2011-06-06. 1722:American Psychiatric Association 1413:) in treating delirium is weak. 904: 7582:Intermittent explosive disorder 7507:Ego-dystonic sexual orientation 7145:from the original on 2020-07-30 7070:from the original on 2019-07-05 6773: 6755:from the original on 4 May 2019 6090: 6057: 5911: 5747: 5715:Critical Care Neurology Part II 5663: 5620: 5571: 5520: 5471: 5427: 5334: 5293: 5183: 5172:from the original on 2023-12-30 5145: 5130: 5055:from the original on 2019-12-23 5037: 4898:from the original on 2019-12-23 4880: 4837: 4779: 4668:from the original on 2019-03-22 4491: 4450: 4407: 4348: 4297: 4256: 4213: 4164: 4115: 4072: 4023: 3973: 3930: 3910: 3874: 3847: 3836:from the original on 2023-06-09 3760: 3711: 3662: 3613: 3578: 3382: 3371:from the original on 2021-08-28 3252: 3195: 3138: 3062:10.1590/S1807-59322011001000024 3037: 2988: 2931: 2874: 2789: 2778:from the original on 2021-08-28 2673: 2630: 2468: 2355: 2312: 2277: 2241: 2189:from the original on 2004-10-17 2182:. bluebook.doc. pp. 56–7. 2154: 2056:from the original on 2019-11-07 1854:from the original on 2022-12-06 1639:Nature Reviews. Disease Primers 1502: 977: 618: 329: 265:), substance withdrawal (e.g., 127:Days to weeks, sometimes months 8225:Dissociative identity disorder 7490:Adult personality and behavior 6177:10.1002/14651858.CD004770.pub3 5824:10.1002/14651858.cd009537.pub3 5772:10.1002/14651858.CD012317.pub2 5261:10.1002/14651858.CD013307.pub3 4567:10.1002/14651858.CD011749.pub2 2032:10.1002/14651858.CD005594.pub3 1926:10.1002/14651858.CD005563.pub3 1875: 1865: 1740: 1372: 937:among diseased animals. Prior 764:Primary neurologic conditions 13: 1: 7276:Grassi L, Caraceni A (2003). 7169:Archives of Internal Medicine 5449:10.1016/j.archger.2019.103963 5208:10.1016/S2215-0366(14)70281-0 5155:Dementia: A Clinical Approach 3102:Brain, Behavior, and Immunity 2957:10.1080/13607863.2021.1989375 2799:European Journal of Neurology 1561: 1225: 1070:mini–mental state examination 859:Metabolic derangements (e.g. 657:Psychiatric morbidity (e.g., 366: 8732:Psychopathological syndromes 8629:Pseudoneurotic schizophrenia 8166:Generalized anxiety disorder 7899:Neurological and symptomatic 7544:Sexual relationship disorder 7181:10.1001/archinternmed.2007.4 6546:10.1212/WNL.0b013e3181a4129a 6497:10.1212/WNL.0b013e31824d5894 5936:10.1213/ANE.0b013e3182147f6d 5641:10.1097/CCM.0000000000001952 5596:10.1016/j.amjmed.2015.05.026 5084:Indian Journal of Psychiatry 4858:10.1097/MCC.0b013e32835132b9 4806:10.1097/PCC.0000000000002873 4428:10.3109/02699052.2010.498008 4177:Annals of Emergency Medicine 4093:10.7326/0003-4819-113-12-941 2651:10.1097/MCC.0b013e328357effa 2502:10.1371/journal.pone.0193034 1490:Post-intensive care syndrome 1454: 1311: 1075: 714:Inadequately controlled pain 570:fluctuating emotional states 465:. Older memories already in 332:). According to the text of 7: 8405:REM sleep behavior disorder 7874:Seasonal affective disorder 7672:Separation anxiety disorder 6966:10.1016/j.jamda.2008.09.006 6919:General Hospital Psychiatry 6819:10.1136/bmjopen-2012-001772 4919:Soiza; Myint (2019-08-15). 4501:General Hospital Psychiatry 4128:Annals of Internal Medicine 4081:Annals of Internal Medicine 3781:10.1016/j.jamda.2021.02.029 2887:General Hospital Psychiatry 2740:"Delirium in older persons" 2298:10.1056/NEJM198903023200907 1114:Confusion Assessment Method 10: 8748: 8672:Symptoms and uncategorized 7773:developmental disabilities 7539:Sexual maturation disorder 6064:Tyrer PJ, Silk KR (2008). 5359:10.1016/j.jagp.2018.06.007 4234:10.1891/rtnp.17.1.31.53169 3951:10.1016/j.psym.2016.06.001 3896:10.1016/j.ejim.2015.08.006 3638:10.1016/j.jcrc.2010.05.004 1652:10.1038/s41572-020-00223-4 1595:10.1007/s00134-019-05907-4 1487: 1208:depersonalization disorder 1195:: In general, people with 987:magnetic resonance imaging 642:Physical morbidity (e.g., 619:Delirium § Prevention 520:, impaired comprehension, 330:Delirium § Prevention 29: 8677: 8666: 8642: 8634:Simple-type schizophrenia 8611: 8603:Schizophreniform disorder 8580: 8559: 8555: 8534: 8487: 8469: 8438: 8415: 8369: 8336: 8332: 8321: 8243: 8210: 8158: 8101: 8092: 8073: 8069: 8048: 8014: 7981:Mild cognitive impairment 7966:Creutzfeldt–Jakob disease 7946: 7908: 7904: 7893: 7864:Major depressive disorder 7817: 7803: 7769:Psychological development 7768: 7743: 7640: 7636: 7623: 7552: 7499: 7495: 7484: 7393: 7323: 7130:Barrough, Philip (1583). 6751:. National Public Radio. 6696:Current Neuropharmacology 6103:Current Neuropharmacology 5684:10.1007/s00391-013-0598-1 5546:10.1186/s12939-019-1112-1 5158:. Butterworth-Heinemann. 4323:10.1186/s12912-015-0070-1 3403:10.1007/s00401-010-0674-1 3114:10.1016/j.bbi.2012.07.012 2944:Aging & Mental Health 2594:Nature Reviews. Neurology 2376:10.1080/09540260802675460 2175:World Health Organization 1753:American Family Physician 1747:Gleason OC (March 2003). 1484:Dementia in ICU survivors 1441:antipsychotic medications 1418:dementia with Lewy bodies 1403:dementia with Lewy bodies 1349:Multidomain interventions 783:transient ischemic attack 608: 263:hallucinogenic deliriants 191: 183: 171: 147: 139: 131: 123: 115: 71: 47: 42: 32:Delirium (disambiguation) 8682:Impulse-control disorder 8598:Schizoaffective disorder 8593:Brief reactive psychosis 8290:Mass psychogenic illness 8253:Body dysmorphic disorder 8032:Post-concussion syndrome 7642:Emotional and behavioral 7116:. Available for free on 7048:10.1177/0957154X07076467 5924:Anesthesia and Analgesia 5097:10.4103/0019-5545.224473 4938:10.3390/medicina55080491 4708:10.1001/jama.286.21.2703 3626:Journal of Critical Care 2738:Inouye SK (March 2006). 2606:10.1038/nrneurol.2009.24 2139:10.1001/jama.291.14.1753 1552: 1276:cholinesterase inhibitor 817:urinary tract infections 8727:Intensive care medicine 8619:Childhood schizophrenia 7971:Frontotemporal dementia 7928:High-functioning autism 7745:Intellectual disability 6632:10.1378/chest.130.3.869 6033:10.1001/jama.2017.12067 5005:10.1001/jama.2017.12067 4745:Intensive Care Medicine 4036:Delirium Communications 3013:10.1093/gerona/63.7.764 1583:Intensive Care Medicine 1383:atypical antipsychotics 1010:functional connectivity 769:orthostatic hypotension 652:cerebrovascular disease 633:65 or more years of age 600:Mixed level of activity 580:Motor activity changes: 552:Perceptual disturbances 528:Sleep/wake disturbances 290:organic brain syndromes 253:the brain or a process 208:acute confusional state 54:Intensive care medicine 8136:Specific social phobia 8027:Organic brain syndrome 7869:Melancholic depression 7630:Childhood and learning 6396:10.1001/jama.2010.1553 6339:10.1093/ageing/afac051 6238:10.1001/jama.2010.1013 5629:Critical Care Medicine 5196:The Lancet. Psychiatry 5090:(Suppl 3): S329–S340. 4609:Critical Care Medicine 4374:10.1093/ageing/afaa224 3220:10.22122/ahj.v12i1.257 3208:Addiction & Health 1527:Aulus Cornelius Celsus 1204:Other mental illnesses 1152:Differential diagnosis 1022:Electroencephalography 948:central nervous system 773:cerebral hypoperfusion 700: 173:Differential diagnosis 8692:Psychomotor agitation 8482:and substance-related 8425:Postpartum depression 8305:Somatization disorder 8191:Acute stress reaction 7956:AIDS dementia complex 7231:10.1093/ageing/afr147 7036:History of Psychiatry 7001:10.1192/bjp.139.5.439 6895:10.1093/ageing/afl005 6596:10.1093/ageing/afn253 6448:10.1001/jama.2010.167 5903:) CS1 maint: others ( 5393:Waite, L. J. (2004). 5319:10.1093/ageing/afu173 4757:10.1007/s001340100909 3687:10.1089/rej.2011.1185 3675:Rejuvenation Research 3391:Acta Neuropathologica 2859:10.1093/ageing/afq140 2446:10.1192/bjp.161.6.843 789:Intracranial bleeding 691: 684:Precipitating factors 644:biventricular failure 636:Cognitive impairment/ 510:Language disturbances 488:Disorganized thinking 484:Disorganized thinking 286:psychiatric disorders 158:neurological problems 8687:Klüver–Bucy syndrome 8517:Substance dependence 8430:Postpartum psychosis 7976:Huntington's disease 7758:Lujan–Fryns syndrome 7607:Personality disorder 6774:Ely EW, et al. 6290:10.1093/brain/aws190 5590:(10): 1126–1137.e1. 5405:(Supplement): 3–16. 3278:10.21037/atm-20-4498 2756:10.1056/NEJMra052321 1335:Maintaining mobility 1177:Huntington's disease 678:alcohol use disorder 625:Predisposing factors 554:: These can include 247:acute encephalopathy 245:process known as an 8722:Cognitive disorders 8567:Delusional disorder 8512:Stimulant psychosis 8502:Physical dependence 8356:Rumination syndrome 8258:Conversion disorder 8235:Psychogenic amnesia 8085:with depressed mood 8083:Adjustment disorder 7986:Parkinson's disease 7961:Alzheimer's disease 7854:Atypical depression 7690:Social functioning 7565:Munchausen syndrome 7560:Factitious disorder 7259:Delirium in old age 7114:The Pickwick Papers 7042:(72 Pt 4): 459–69. 5049:www.reliasmedia.com 4662:www.icudelirium.org 4048:10.56392/001c.84051 3868:10.56392/001c.74541 2493:2018PLoSO..1393034M 1844:"SIGN 157 Delirium" 1542:The Pickwick Papers 1521:Society and culture 1423:The antidepressant 1399:Parkinson's disease 1393:, ziprasidone, and 1251:Non-pharmacological 1139:Intensive care unit 960:cerebrospinal fluid 954:Cerebrospinal fluid 804:Concurrent illness 750:, corticosteroids, 439:: A disturbance in 377:medical terminology 8586:schizophrenia-like 8230:Dissociative fugue 7679:Movement disorders 7394:External resources 4892:www.ebmedicine.net 3924:2023-12-30 at the 1284:methylprednisolone 1091:cognitive function 756:General anesthetic 701: 694:alcohol withdrawal 496:loose associations 419:Signs and symptoms 8709: 8708: 8705: 8704: 8662: 8661: 8658: 8657: 8530: 8529: 8465: 8464: 8461: 8460: 8317: 8316: 8313: 8312: 8206: 8205: 8044: 8043: 8040: 8039: 8001:Vascular dementia 7923:Asperger syndrome 7889: 7888: 7799: 7798: 7795: 7794: 7733:Tourette syndrome 7619: 7618: 7615: 7614: 7439: 7438: 7268:978-0-19-263275-3 7118:Project Gutenberg 7112:Dickens C (1837) 7099:978-0-7020-2627-0 6284:(Pt 9): 2809–16. 6027:(12): 1161–1174. 5991:978-1-61537-187-7 5635:(12): 2231–2240. 5497:10.1111/jgs.16565 5353:(10): 1015–1033. 5165:978-0-7506-7470-6 4999:(12): 1161–1174. 4000:10.1111/jgs.18751 3554:10.1111/jgs.14748 3458:(11): 1458–1478. 3333:(11): 1479–1500. 3151:JAMA Network Open 2950:(10): 2054–2061. 2811:10.1111/ene.14749 2545:JAMA Network Open 2162:Sartorius, Norman 1983:10.1111/jgs.14076 1883:Crit. Care Nurs.. 1173:Alzheimer disease 967:systematic review 881:Mercury poisoning 865:Addison's disease 492:poverty of speech 455:memory impairment 451:Memory impairment 319:sedative-hypnotic 312:breathing tube). 201: 200: 162:sleep deprivation 37:Medical condition 16:(Redirected from 8739: 8668: 8667: 8557: 8556: 8536: 8535: 8471: 8470: 8346:Anorexia nervosa 8334: 8333: 8323: 8322: 8300:Psychogenic pain 8268:Globus pharyngis 8116:Childhood phobia 8099: 8098: 8071: 8070: 8050: 8049: 7906: 7905: 7895: 7894: 7805: 7804: 7704:Selective mutism 7655:Conduct disorder 7638: 7637: 7625: 7624: 7602:Trichotillomania 7577:Gender dysphoria 7572:Fear of intimacy 7529:Sexual anhedonia 7497: 7496: 7486: 7485: 7473:Mental disorders 7466: 7459: 7452: 7443: 7442: 7321: 7320: 7310: 7291: 7272: 7244: 7243: 7233: 7209: 7203: 7202: 7192: 7160: 7154: 7153: 7151: 7150: 7127: 7121: 7110: 7104: 7103: 7085: 7079: 7078: 7076: 7075: 7027: 7021: 7020: 6984: 6978: 6977: 6949: 6943: 6942: 6914: 6908: 6907: 6897: 6873: 6867: 6866: 6852: 6841: 6840: 6830: 6798: 6792: 6791: 6789: 6787: 6771: 6765: 6764: 6762: 6760: 6744: 6738: 6737: 6727: 6702:(9): 1519–1544. 6687: 6681: 6680: 6678: 6676: 6661: 6652: 6651: 6615: 6609: 6608: 6598: 6574: 6568: 6567: 6557: 6525: 6519: 6518: 6508: 6476: 6470: 6469: 6459: 6427: 6418: 6417: 6407: 6375: 6369: 6368: 6358: 6318: 6312: 6311: 6301: 6269: 6258: 6257: 6220: 6207: 6206: 6196: 6156: 6145: 6144: 6134: 6109:(9): 1519–1544. 6094: 6088: 6087: 6061: 6055: 6054: 6044: 6012: 6003: 6002: 5969: 5958: 5957: 5947: 5915: 5909: 5908: 5898: 5890: 5865: 5854: 5853: 5843: 5803: 5794: 5793: 5783: 5751: 5745: 5744: 5710: 5704: 5703: 5667: 5661: 5660: 5624: 5618: 5617: 5607: 5575: 5569: 5568: 5558: 5548: 5524: 5518: 5517: 5499: 5490:(8): 1864–1871. 5475: 5469: 5468: 5431: 5425: 5424: 5414: 5390: 5381: 5380: 5370: 5338: 5332: 5331: 5321: 5297: 5291: 5290: 5280: 5255:(11): CD013307. 5239: 5230: 5229: 5219: 5187: 5181: 5180: 5178: 5177: 5149: 5143: 5134: 5128: 5127: 5117: 5099: 5075: 5064: 5063: 5061: 5060: 5041: 5035: 5034: 5024: 4984: 4969: 4968: 4958: 4940: 4916: 4907: 4906: 4904: 4903: 4884: 4878: 4877: 4841: 4835: 4834: 4808: 4783: 4777: 4776: 4740: 4731: 4730: 4720: 4710: 4686: 4677: 4676: 4674: 4673: 4654: 4641: 4640: 4603: 4597: 4596: 4586: 4546: 4533: 4532: 4495: 4489: 4488: 4478: 4454: 4448: 4447: 4411: 4405: 4404: 4394: 4376: 4352: 4346: 4345: 4335: 4325: 4301: 4295: 4294: 4284: 4260: 4254: 4253: 4217: 4211: 4210: 4200: 4168: 4162: 4161: 4151: 4140:10.7326/M14-0865 4119: 4113: 4112: 4076: 4070: 4069: 4059: 4027: 4021: 4020: 4002: 3993:(5): 1508–1524. 3977: 3971: 3970: 3934: 3928: 3914: 3908: 3907: 3878: 3872: 3871: 3851: 3845: 3844: 3842: 3841: 3832:. 28 July 2010. 3822: 3801: 3800: 3775:(7): 1535–1542. 3764: 3758: 3757: 3747: 3715: 3709: 3708: 3698: 3666: 3660: 3659: 3649: 3632:(3): 538.e7–12. 3617: 3611: 3610: 3582: 3576: 3575: 3565: 3548:(6): 1114–1118. 3533: 3522: 3521: 3493: 3484: 3483: 3464:10.1002/gps.4724 3446: 3433: 3432: 3414: 3386: 3380: 3379: 3377: 3376: 3350: 3339:10.1002/gps.4720 3318: 3309: 3308: 3298: 3280: 3256: 3250: 3249: 3239: 3199: 3193: 3192: 3182: 3142: 3136: 3135: 3125: 3093: 3084: 3083: 3073: 3041: 3035: 3034: 3024: 2992: 2986: 2985: 2959: 2935: 2929: 2928: 2918: 2878: 2872: 2871: 2861: 2837: 2831: 2830: 2805:(5): 1590–1600. 2793: 2787: 2786: 2784: 2783: 2735: 2714: 2713: 2677: 2671: 2670: 2634: 2628: 2627: 2617: 2585: 2579: 2578: 2568: 2536: 2525: 2524: 2514: 2504: 2472: 2466: 2465: 2429: 2420: 2419: 2402: 2396: 2395: 2359: 2353: 2352: 2333:10.1002/gps.1343 2316: 2310: 2309: 2281: 2275: 2274: 2245: 2239: 2238: 2212: 2203: 2202: 2196: 2194: 2188: 2170: 2158: 2152: 2151: 2141: 2114: 2108: 2107: 2071: 2065: 2064: 2062: 2061: 2043: 2011: 2005: 2004: 1994: 1962: 1956: 1955: 1945: 1905: 1886: 1879: 1873: 1869: 1863: 1862: 1860: 1859: 1840: 1831: 1830: 1820: 1788: 1773: 1772: 1744: 1738: 1737: 1735: 1733: 1714: 1691: 1690: 1672: 1654: 1630: 1617: 1616: 1606: 1589:(5): 1020–1022. 1574: 1240:Sharon K. Inouye 1097:General settings 744:anticholinergics 723:Emotional stress 698:delirium tremens 696:, also known as 279:bipolar disorder 228:sleep-wake cycle 110:thought disorder 40: 39: 21: 8747: 8746: 8742: 8741: 8740: 8738: 8737: 8736: 8712: 8711: 8710: 8701: 8673: 8654: 8638: 8607: 8585: 8576: 8551: 8526: 8483: 8480:substance abuse 8457: 8434: 8411: 8365: 8351:Bulimia nervosa 8328: 8309: 8285:Hypochondriasis 8280:False pregnancy 8263:Ganser syndrome 8245:Somatic symptom 8239: 8202: 8154: 8143:Specific phobia 8088: 8065: 8036: 8010: 7942: 7938:Savant syndrome 7910:Autism spectrum 7900: 7885: 7813: 7791: 7770: 7764: 7739: 7632: 7611: 7587:Dermatillomania 7548: 7534:Sexual anorexia 7491: 7480: 7470: 7440: 7435: 7434: 7389: 7388: 7332: 7318: 7313: 7307: 7288: 7269: 7252: 7250:Further reading 7247: 7210: 7206: 7161: 7157: 7148: 7146: 7128: 7124: 7111: 7107: 7100: 7088:Sims A (2002). 7086: 7082: 7073: 7071: 7028: 7024: 6985: 6981: 6950: 6946: 6915: 6911: 6874: 6870: 6853: 6844: 6799: 6795: 6785: 6783: 6772: 6768: 6758: 6756: 6745: 6741: 6688: 6684: 6674: 6672: 6662: 6655: 6616: 6612: 6575: 6571: 6526: 6522: 6477: 6473: 6428: 6421: 6390:(16): 1787–94. 6376: 6372: 6319: 6315: 6270: 6261: 6221: 6210: 6171:(1): CD004770. 6157: 6148: 6095: 6091: 6076: 6062: 6058: 6013: 6006: 5992: 5970: 5961: 5916: 5912: 5892: 5891: 5879: 5867: 5866: 5857: 5818:(4): CD009537. 5804: 5797: 5766:(8): CD012317. 5752: 5748: 5733: 5711: 5707: 5668: 5664: 5625: 5621: 5576: 5572: 5525: 5521: 5476: 5472: 5432: 5428: 5391: 5384: 5339: 5335: 5298: 5294: 5240: 5233: 5188: 5184: 5175: 5173: 5166: 5150: 5146: 5135: 5131: 5076: 5067: 5058: 5056: 5043: 5042: 5038: 4985: 4972: 4917: 4910: 4901: 4899: 4886: 4885: 4881: 4842: 4838: 4799:(2): e74–e110. 4784: 4780: 4741: 4734: 4701:(21): 2703–10. 4687: 4680: 4671: 4669: 4656: 4655: 4644: 4604: 4600: 4561:(9): CD011749. 4547: 4536: 4496: 4492: 4455: 4451: 4422:(10): 1222–30. 4412: 4408: 4353: 4349: 4302: 4298: 4261: 4257: 4218: 4214: 4169: 4165: 4120: 4116: 4077: 4073: 4028: 4024: 3978: 3974: 3935: 3931: 3926:Wayback Machine 3915: 3911: 3879: 3875: 3852: 3848: 3839: 3837: 3824: 3823: 3804: 3765: 3761: 3724:JAMA Psychiatry 3716: 3712: 3667: 3663: 3618: 3614: 3583: 3579: 3534: 3525: 3494: 3487: 3447: 3436: 3387: 3383: 3374: 3372: 3319: 3312: 3257: 3253: 3200: 3196: 3157:(1): e2249950. 3143: 3139: 3094: 3087: 3056:(10): 1825–31. 3042: 3038: 2993: 2989: 2936: 2932: 2879: 2875: 2838: 2834: 2794: 2790: 2781: 2779: 2750:(11): 1157–65. 2736: 2717: 2688:(10): 1327–34. 2678: 2674: 2635: 2631: 2586: 2582: 2551:(1): e2249950. 2537: 2528: 2487:(2): e0193034. 2473: 2469: 2430: 2423: 2416: 2404: 2403: 2399: 2360: 2356: 2317: 2313: 2282: 2278: 2246: 2242: 2227: 2213: 2206: 2192: 2190: 2186: 2168: 2159: 2155: 2132:(14): 1753–62. 2115: 2111: 2072: 2068: 2059: 2057: 2026:(6): CD005594. 2012: 2008: 1963: 1959: 1920:(3): CD005563. 1906: 1889: 1880: 1876: 1870: 1866: 1857: 1855: 1842: 1841: 1834: 1789: 1776: 1745: 1741: 1731: 1729: 1716: 1715: 1694: 1631: 1620: 1575: 1568: 1564: 1555: 1537:Charles Dickens 1523: 1505: 1492: 1486: 1457: 1432:Dexmedetomidine 1411:benzodiazepines 1375: 1357: 1351: 1314: 1267: 1265:Pharmacological 1253: 1228: 1154: 1141: 1099: 1078: 1038: 1030:neuroplasticity 1019: 1017:Neurophysiology 980: 956: 921:drugs, such as 919:anticholinergic 907: 899: 897:Pathophysiology 869:hyperthyroidism 736:benzodiazepines 686: 627: 611: 478:Disorientation: 421: 369: 349:Diphenhydramine 345:Anticholinergic 326:benzodiazepines 296:in common with 102:memory problems 38: 35: 28: 23: 22: 15: 12: 11: 5: 8745: 8735: 8734: 8729: 8724: 8707: 8706: 8703: 8702: 8700: 8699: 8694: 8689: 8684: 8678: 8675: 8674: 8664: 8663: 8660: 8659: 8656: 8655: 8653: 8652: 8646: 8644: 8640: 8639: 8637: 8636: 8631: 8626: 8621: 8615: 8613: 8609: 8608: 8606: 8605: 8600: 8595: 8589: 8587: 8578: 8577: 8575: 8574: 8569: 8563: 8561: 8553: 8552: 8532: 8531: 8528: 8527: 8525: 8524: 8519: 8514: 8509: 8507:Rebound effect 8504: 8499: 8494: 8488: 8485: 8484: 8467: 8466: 8463: 8462: 8459: 8458: 8456: 8455: 8450: 8448:Hypersexuality 8444: 8442: 8436: 8435: 8433: 8432: 8427: 8421: 8419: 8413: 8412: 8410: 8409: 8408: 8407: 8402: 8397: 8387: 8382: 8376: 8374: 8367: 8366: 8364: 8363: 8358: 8353: 8348: 8342: 8340: 8330: 8329: 8319: 8318: 8315: 8314: 8311: 8310: 8308: 8307: 8302: 8297: 8292: 8287: 8282: 8277: 8276: 8275: 8270: 8265: 8255: 8249: 8247: 8241: 8240: 8238: 8237: 8232: 8227: 8222: 8216: 8214: 8208: 8207: 8204: 8203: 8201: 8200: 8199: 8198: 8193: 8183: 8181:Panic disorder 8178: 8173: 8168: 8162: 8160: 8156: 8155: 8153: 8152: 8151: 8150: 8148:Claustrophobia 8140: 8139: 8138: 8133: 8131:Anthropophobia 8123: 8121:Social anxiety 8118: 8113: 8107: 8105: 8096: 8090: 8089: 8087: 8086: 8079: 8077: 8067: 8066: 8046: 8045: 8042: 8041: 8038: 8037: 8035: 8034: 8029: 8024: 8018: 8016: 8012: 8011: 8009: 8008: 8003: 7998: 7993: 7991:Pick's disease 7988: 7983: 7978: 7973: 7968: 7963: 7958: 7952: 7950: 7944: 7943: 7941: 7940: 7935: 7930: 7925: 7920: 7914: 7912: 7902: 7901: 7891: 7890: 7887: 7886: 7884: 7883: 7878: 7877: 7876: 7871: 7866: 7861: 7856: 7846: 7845: 7844: 7839: 7834: 7829: 7818: 7815: 7814: 7801: 7800: 7797: 7796: 7793: 7792: 7790: 7789: 7784: 7778: 7776: 7766: 7765: 7763: 7762: 7761: 7760: 7749: 7747: 7741: 7740: 7738: 7737: 7736: 7735: 7725: 7724: 7723: 7718: 7708: 7707: 7706: 7701: 7696: 7688: 7687: 7686: 7676: 7675: 7674: 7664: 7663: 7662: 7652: 7646: 7644: 7634: 7633: 7621: 7620: 7617: 7616: 7613: 7612: 7610: 7609: 7604: 7599: 7594: 7589: 7584: 7579: 7574: 7569: 7568: 7567: 7556: 7554: 7550: 7549: 7547: 7546: 7541: 7536: 7531: 7526: 7525: 7524: 7519: 7509: 7503: 7501: 7493: 7492: 7482: 7481: 7477:Classification 7469: 7468: 7461: 7454: 7446: 7437: 7436: 7433: 7432: 7421: 7410: 7398: 7397: 7395: 7391: 7390: 7387: 7386: 7375: 7364: 7349: 7333: 7328: 7327: 7325: 7324:Classification 7317: 7316:External links 7314: 7312: 7311: 7306:978-1613242940 7305: 7292: 7287:978-0192631992 7286: 7273: 7267: 7253: 7251: 7248: 7246: 7245: 7218:Age and Ageing 7204: 7155: 7138:] medicine 7122: 7105: 7098: 7080: 7022: 6979: 6944: 6909: 6882:Age and Ageing 6868: 6865:on 2014-09-08. 6842: 6813:(1): e001772. 6793: 6766: 6739: 6682: 6653: 6610: 6583:Age and Ageing 6569: 6540:(18): 1570–5. 6520: 6471: 6419: 6370: 6333:(3): afac051. 6327:Age and Ageing 6313: 6259: 6208: 6146: 6089: 6074: 6056: 6004: 5990: 5959: 5930:(5): 1202–11. 5910: 5877: 5855: 5795: 5746: 5731: 5705: 5662: 5619: 5570: 5519: 5470: 5426: 5382: 5333: 5312:(2): 196–204. 5306:Age and Ageing 5292: 5231: 5182: 5164: 5144: 5129: 5065: 5036: 4970: 4908: 4879: 4836: 4778: 4732: 4678: 4642: 4598: 4534: 4490: 4449: 4406: 4367:(3): 733–743. 4361:Age and Ageing 4347: 4296: 4255: 4212: 4183:(5): 457–465. 4163: 4134:(8): 554–561. 4114: 4071: 4022: 3972: 3939:Psychosomatics 3929: 3909: 3890:(9): 696–704. 3873: 3846: 3802: 3759: 3730:(3): 244–251. 3710: 3661: 3612: 3577: 3523: 3504:(3): 239–248. 3485: 3434: 3381: 3310: 3251: 3194: 3137: 3085: 3036: 2987: 2930: 2873: 2846:Age and Ageing 2832: 2788: 2715: 2672: 2629: 2580: 2526: 2467: 2421: 2414: 2397: 2354: 2311: 2276: 2240: 2225: 2204: 2199:Microsoft Bing 2180:Microsoft Word 2153: 2109: 2066: 2006: 1957: 1887: 1874: 1864: 1848:www.sign.ac.uk 1832: 1803:(4): 356–364. 1774: 1759:(5): 1027–34. 1739: 1692: 1618: 1565: 1563: 1560: 1554: 1551: 1522: 1519: 1504: 1501: 1485: 1482: 1456: 1453: 1449:extrapyramidal 1407:antipsychotics 1374: 1371: 1355: 1350: 1347: 1346: 1345: 1342: 1339: 1336: 1333: 1330: 1327: 1324: 1313: 1310: 1266: 1263: 1252: 1249: 1227: 1224: 1223: 1222: 1201: 1190: 1180: 1153: 1150: 1140: 1137: 1136: 1135: 1132: 1126: 1123: 1120: 1117: 1098: 1095: 1077: 1074: 1037: 1036:Neuropathology 1034: 1018: 1015: 979: 976: 955: 952: 906: 903: 898: 895: 894: 893: 890: 889: 888: 878: 875: 872: 857: 844: 838: 825: 819: 802: 801: 800: 791: 786: 776: 762: 761: 760: 757: 754: 729: 728: 727: 724: 721: 718: 715: 709: 685: 682: 681: 680: 674: 668: 665: 662: 655: 640: 634: 626: 623: 610: 607: 606: 605: 604: 603: 597: 591: 577: 563: 560:hallucinations 549: 536:: Symptoms of 531: 525: 514:Anomic aphasia 507: 481: 475: 448: 420: 417: 416: 415: 412: 409: 402: 399: 368: 365: 357:Dimenhydrinate 314:Antipsychotics 232:hallucinations 199: 198: 195: 189: 188: 185: 181: 180: 175: 169: 168: 151: 145: 144: 141: 137: 136: 133: 129: 128: 125: 121: 120: 117: 113: 112: 90:hallucinations 75: 69: 68: 51: 45: 44: 36: 26: 9: 6: 4: 3: 2: 8744: 8733: 8730: 8728: 8725: 8723: 8720: 8719: 8717: 8698: 8695: 8693: 8690: 8688: 8685: 8683: 8680: 8679: 8676: 8669: 8665: 8651: 8648: 8647: 8645: 8641: 8635: 8632: 8630: 8627: 8625: 8622: 8620: 8617: 8616: 8614: 8612:Schizophrenia 8610: 8604: 8601: 8599: 8596: 8594: 8591: 8590: 8588: 8583: 8579: 8573: 8570: 8568: 8565: 8564: 8562: 8558: 8554: 8550: 8546: 8542: 8541:Schizophrenia 8537: 8533: 8523: 8520: 8518: 8515: 8513: 8510: 8508: 8505: 8503: 8500: 8498: 8495: 8493: 8492:Drug overdose 8490: 8489: 8486: 8481: 8477: 8472: 8468: 8454: 8451: 8449: 8446: 8445: 8443: 8441: 8440:Sexual desire 8437: 8431: 8428: 8426: 8423: 8422: 8420: 8418: 8414: 8406: 8403: 8401: 8398: 8396: 8393: 8392: 8391: 8388: 8386: 8383: 8381: 8378: 8377: 8375: 8373: 8368: 8362: 8359: 8357: 8354: 8352: 8349: 8347: 8344: 8343: 8341: 8339: 8335: 8331: 8324: 8320: 8306: 8303: 8301: 8298: 8296: 8293: 8291: 8288: 8286: 8283: 8281: 8278: 8274: 8271: 8269: 8266: 8264: 8261: 8260: 8259: 8256: 8254: 8251: 8250: 8248: 8246: 8242: 8236: 8233: 8231: 8228: 8226: 8223: 8221: 8218: 8217: 8215: 8213: 8209: 8197: 8194: 8192: 8189: 8188: 8187: 8184: 8182: 8179: 8177: 8174: 8172: 8169: 8167: 8164: 8163: 8161: 8157: 8149: 8146: 8145: 8144: 8141: 8137: 8134: 8132: 8129: 8128: 8127: 8126:Social phobia 8124: 8122: 8119: 8117: 8114: 8112: 8109: 8108: 8106: 8104: 8100: 8097: 8095: 8091: 8084: 8081: 8080: 8078: 8076: 8072: 8068: 8064: 8061:-related and 8060: 8056: 8051: 8047: 8033: 8030: 8028: 8025: 8023: 8020: 8019: 8017: 8013: 8007: 8004: 8002: 7999: 7997: 7994: 7992: 7989: 7987: 7984: 7982: 7979: 7977: 7974: 7972: 7969: 7967: 7964: 7962: 7959: 7957: 7954: 7953: 7951: 7949: 7945: 7939: 7936: 7934: 7931: 7929: 7926: 7924: 7921: 7919: 7916: 7915: 7913: 7911: 7907: 7903: 7896: 7892: 7882: 7879: 7875: 7872: 7870: 7867: 7865: 7862: 7860: 7857: 7855: 7852: 7851: 7850: 7847: 7843: 7840: 7838: 7835: 7833: 7830: 7828: 7825: 7824: 7823: 7820: 7819: 7816: 7811: 7806: 7802: 7788: 7785: 7783: 7780: 7779: 7777: 7774: 7767: 7759: 7756: 7755: 7754: 7751: 7750: 7748: 7746: 7742: 7734: 7731: 7730: 7729: 7726: 7722: 7719: 7717: 7714: 7713: 7712: 7709: 7705: 7702: 7700: 7697: 7695: 7692: 7691: 7689: 7685: 7682: 7681: 7680: 7677: 7673: 7670: 7669: 7668: 7665: 7661: 7658: 7657: 7656: 7653: 7651: 7648: 7647: 7645: 7643: 7639: 7635: 7631: 7626: 7622: 7608: 7605: 7603: 7600: 7598: 7595: 7593: 7590: 7588: 7585: 7583: 7580: 7578: 7575: 7573: 7570: 7566: 7563: 7562: 7561: 7558: 7557: 7555: 7551: 7545: 7542: 7540: 7537: 7535: 7532: 7530: 7527: 7523: 7520: 7518: 7515: 7514: 7513: 7510: 7508: 7505: 7504: 7502: 7498: 7494: 7487: 7483: 7478: 7474: 7467: 7462: 7460: 7455: 7453: 7448: 7447: 7444: 7431: 7427: 7426: 7422: 7420: 7416: 7415: 7411: 7409: 7405: 7404: 7400: 7399: 7396: 7392: 7385: 7381: 7380: 7376: 7374: 7370: 7369: 7365: 7363: 7359: 7358: 7354: 7350: 7348: 7344: 7343: 7339: 7335: 7334: 7331: 7326: 7322: 7308: 7302: 7298: 7293: 7289: 7283: 7279: 7274: 7270: 7264: 7260: 7255: 7254: 7241: 7237: 7232: 7227: 7224:(3): 285–91. 7223: 7219: 7215: 7208: 7200: 7196: 7191: 7186: 7182: 7178: 7174: 7170: 7166: 7159: 7144: 7140: 7139: 7135: 7134:ech [ 7126: 7119: 7115: 7109: 7101: 7095: 7091: 7084: 7069: 7065: 7061: 7057: 7053: 7049: 7045: 7041: 7037: 7033: 7026: 7018: 7014: 7010: 7006: 7002: 6998: 6995:(5): 439–49. 6994: 6990: 6983: 6975: 6971: 6967: 6963: 6959: 6955: 6948: 6940: 6936: 6932: 6928: 6924: 6920: 6913: 6905: 6901: 6896: 6891: 6888:(4): 350–64. 6887: 6883: 6879: 6872: 6864: 6860: 6859: 6851: 6849: 6847: 6838: 6834: 6829: 6824: 6820: 6816: 6812: 6808: 6804: 6797: 6781: 6777: 6770: 6754: 6750: 6743: 6735: 6731: 6726: 6721: 6717: 6713: 6709: 6705: 6701: 6697: 6693: 6686: 6671: 6667: 6660: 6658: 6649: 6645: 6641: 6637: 6633: 6629: 6626:(3): 869–78. 6625: 6621: 6614: 6606: 6602: 6597: 6592: 6588: 6584: 6580: 6573: 6565: 6561: 6556: 6551: 6547: 6543: 6539: 6535: 6531: 6524: 6516: 6512: 6507: 6502: 6498: 6494: 6491:(13): 950–6. 6490: 6486: 6482: 6475: 6467: 6463: 6458: 6453: 6449: 6445: 6442:(8): 763–70. 6441: 6437: 6433: 6426: 6424: 6415: 6411: 6406: 6401: 6397: 6393: 6389: 6385: 6381: 6374: 6366: 6362: 6357: 6352: 6348: 6344: 6340: 6336: 6332: 6328: 6324: 6317: 6309: 6305: 6300: 6295: 6291: 6287: 6283: 6279: 6275: 6268: 6266: 6264: 6255: 6251: 6247: 6243: 6239: 6235: 6232:(4): 443–51. 6231: 6227: 6219: 6217: 6215: 6213: 6204: 6200: 6195: 6190: 6186: 6182: 6178: 6174: 6170: 6166: 6162: 6155: 6153: 6151: 6142: 6138: 6133: 6128: 6124: 6120: 6116: 6112: 6108: 6104: 6100: 6093: 6085: 6081: 6077: 6075:9780511393020 6071: 6067: 6060: 6052: 6048: 6043: 6038: 6034: 6030: 6026: 6022: 6018: 6011: 6009: 6001: 5997: 5993: 5987: 5983: 5979: 5975: 5968: 5966: 5964: 5955: 5951: 5946: 5941: 5937: 5933: 5929: 5925: 5921: 5914: 5906: 5902: 5896: 5888: 5884: 5880: 5878:9781909103689 5874: 5870: 5864: 5862: 5860: 5851: 5847: 5842: 5837: 5833: 5829: 5825: 5821: 5817: 5813: 5809: 5802: 5800: 5791: 5787: 5782: 5777: 5773: 5769: 5765: 5761: 5757: 5750: 5742: 5738: 5734: 5732:9780444635990 5728: 5724: 5720: 5716: 5709: 5701: 5697: 5693: 5689: 5685: 5681: 5677: 5673: 5666: 5658: 5654: 5650: 5646: 5642: 5638: 5634: 5630: 5623: 5615: 5611: 5606: 5601: 5597: 5593: 5589: 5585: 5581: 5574: 5566: 5562: 5557: 5552: 5547: 5542: 5538: 5534: 5530: 5523: 5515: 5511: 5507: 5503: 5498: 5493: 5489: 5485: 5481: 5474: 5466: 5462: 5458: 5454: 5450: 5446: 5442: 5438: 5430: 5422: 5418: 5413: 5408: 5404: 5400: 5396: 5389: 5387: 5378: 5374: 5369: 5364: 5360: 5356: 5352: 5348: 5344: 5337: 5329: 5325: 5320: 5315: 5311: 5307: 5303: 5296: 5288: 5284: 5279: 5274: 5270: 5266: 5262: 5258: 5254: 5250: 5246: 5238: 5236: 5227: 5223: 5218: 5213: 5209: 5205: 5202:(4): 303–11. 5201: 5197: 5193: 5186: 5171: 5167: 5161: 5157: 5156: 5148: 5142: 5138: 5133: 5125: 5121: 5116: 5111: 5107: 5103: 5098: 5093: 5089: 5085: 5081: 5074: 5072: 5070: 5054: 5050: 5046: 5040: 5032: 5028: 5023: 5018: 5014: 5010: 5006: 5002: 4998: 4994: 4990: 4983: 4981: 4979: 4977: 4975: 4966: 4962: 4957: 4952: 4948: 4944: 4939: 4934: 4930: 4926: 4922: 4915: 4913: 4897: 4893: 4889: 4883: 4875: 4871: 4867: 4863: 4859: 4855: 4852:(2): 146–51. 4851: 4847: 4840: 4832: 4828: 4824: 4820: 4816: 4812: 4807: 4802: 4798: 4794: 4790: 4782: 4774: 4770: 4766: 4762: 4758: 4754: 4751:(5): 859–64. 4750: 4746: 4739: 4737: 4728: 4724: 4719: 4714: 4709: 4704: 4700: 4696: 4692: 4685: 4683: 4667: 4663: 4659: 4653: 4651: 4649: 4647: 4638: 4634: 4630: 4626: 4622: 4618: 4615:(1): 119–41. 4614: 4610: 4602: 4594: 4590: 4585: 4580: 4576: 4572: 4568: 4564: 4560: 4556: 4552: 4545: 4543: 4541: 4539: 4530: 4526: 4522: 4518: 4514: 4510: 4506: 4502: 4494: 4486: 4482: 4477: 4472: 4469:(3): 213–26. 4468: 4464: 4460: 4453: 4445: 4441: 4437: 4433: 4429: 4425: 4421: 4417: 4410: 4402: 4398: 4393: 4388: 4384: 4380: 4375: 4370: 4366: 4362: 4358: 4351: 4343: 4339: 4334: 4329: 4324: 4319: 4315: 4311: 4307: 4300: 4292: 4288: 4283: 4278: 4275:(4): 368–75. 4274: 4270: 4266: 4259: 4251: 4247: 4243: 4239: 4235: 4231: 4227: 4223: 4216: 4208: 4204: 4199: 4194: 4190: 4186: 4182: 4178: 4174: 4167: 4159: 4155: 4150: 4145: 4141: 4137: 4133: 4129: 4125: 4118: 4110: 4106: 4102: 4098: 4094: 4090: 4087:(12): 941–8. 4086: 4082: 4075: 4067: 4063: 4058: 4053: 4049: 4045: 4041: 4037: 4033: 4026: 4018: 4014: 4010: 4006: 4001: 3996: 3992: 3988: 3984: 3976: 3968: 3964: 3960: 3956: 3952: 3948: 3944: 3940: 3933: 3927: 3923: 3920: 3913: 3905: 3901: 3897: 3893: 3889: 3885: 3877: 3869: 3865: 3861: 3857: 3850: 3835: 3831: 3827: 3821: 3819: 3817: 3815: 3813: 3811: 3809: 3807: 3798: 3794: 3790: 3786: 3782: 3778: 3774: 3770: 3763: 3755: 3751: 3746: 3741: 3737: 3733: 3729: 3725: 3721: 3714: 3706: 3702: 3697: 3692: 3688: 3684: 3681:(6): 615–22. 3680: 3676: 3672: 3665: 3657: 3653: 3648: 3643: 3639: 3635: 3631: 3627: 3623: 3616: 3608: 3604: 3600: 3596: 3593:(4): 526–38. 3592: 3588: 3581: 3573: 3569: 3564: 3559: 3555: 3551: 3547: 3543: 3539: 3532: 3530: 3528: 3519: 3515: 3511: 3507: 3503: 3499: 3492: 3490: 3481: 3477: 3473: 3469: 3465: 3461: 3457: 3453: 3445: 3443: 3441: 3439: 3430: 3426: 3422: 3418: 3413: 3408: 3404: 3400: 3397:(6): 737–54. 3396: 3392: 3385: 3370: 3366: 3362: 3358: 3354: 3349: 3344: 3340: 3336: 3332: 3328: 3324: 3317: 3315: 3306: 3302: 3297: 3292: 3288: 3284: 3279: 3274: 3270: 3266: 3262: 3255: 3247: 3243: 3238: 3233: 3229: 3225: 3221: 3217: 3213: 3209: 3205: 3198: 3190: 3186: 3181: 3176: 3172: 3168: 3164: 3160: 3156: 3152: 3148: 3141: 3133: 3129: 3124: 3119: 3115: 3111: 3107: 3103: 3099: 3092: 3090: 3081: 3077: 3072: 3067: 3063: 3059: 3055: 3051: 3047: 3040: 3032: 3028: 3023: 3018: 3014: 3010: 3007:(7): 764–72. 3006: 3002: 2998: 2991: 2983: 2979: 2975: 2971: 2967: 2963: 2958: 2953: 2949: 2945: 2941: 2934: 2926: 2922: 2917: 2912: 2908: 2904: 2900: 2896: 2892: 2888: 2884: 2877: 2869: 2865: 2860: 2855: 2851: 2847: 2843: 2836: 2828: 2824: 2820: 2816: 2812: 2808: 2804: 2800: 2792: 2777: 2773: 2769: 2765: 2761: 2757: 2753: 2749: 2745: 2741: 2734: 2732: 2730: 2728: 2726: 2724: 2722: 2720: 2711: 2707: 2703: 2699: 2695: 2691: 2687: 2683: 2676: 2668: 2664: 2660: 2656: 2652: 2648: 2645:(5): 518–26. 2644: 2640: 2633: 2625: 2621: 2616: 2611: 2607: 2603: 2600:(4): 210–20. 2599: 2595: 2591: 2584: 2576: 2572: 2567: 2562: 2558: 2554: 2550: 2546: 2542: 2535: 2533: 2531: 2522: 2518: 2513: 2508: 2503: 2498: 2494: 2490: 2486: 2482: 2478: 2471: 2463: 2459: 2455: 2451: 2447: 2443: 2439: 2435: 2428: 2426: 2417: 2415:0-398-03909-7 2411: 2407: 2401: 2393: 2389: 2385: 2381: 2377: 2373: 2369: 2365: 2358: 2350: 2346: 2342: 2338: 2334: 2330: 2327:(7): 609–15. 2326: 2322: 2315: 2307: 2303: 2299: 2295: 2292:(9): 578–82. 2291: 2287: 2280: 2272: 2268: 2264: 2260: 2257:(2): 149–52. 2256: 2252: 2244: 2236: 2232: 2228: 2226:9781585622573 2222: 2218: 2211: 2209: 2200: 2185: 2181: 2177: 2176: 2167: 2163: 2157: 2149: 2145: 2140: 2135: 2131: 2127: 2123: 2119: 2113: 2105: 2101: 2097: 2093: 2089: 2085: 2082:(8): 631–44. 2081: 2077: 2070: 2055: 2051: 2047: 2042: 2037: 2033: 2029: 2025: 2021: 2017: 2010: 2002: 1998: 1993: 1988: 1984: 1980: 1977:(4): 705–14. 1976: 1972: 1968: 1961: 1953: 1949: 1944: 1939: 1935: 1931: 1927: 1923: 1919: 1915: 1911: 1904: 1902: 1900: 1898: 1896: 1894: 1892: 1884: 1878: 1868: 1853: 1849: 1845: 1839: 1837: 1828: 1824: 1819: 1814: 1810: 1806: 1802: 1798: 1794: 1787: 1785: 1783: 1781: 1779: 1770: 1766: 1762: 1758: 1754: 1750: 1743: 1727: 1723: 1719: 1713: 1711: 1709: 1707: 1705: 1703: 1701: 1699: 1697: 1688: 1684: 1680: 1676: 1671: 1666: 1662: 1658: 1653: 1648: 1644: 1640: 1636: 1629: 1627: 1625: 1623: 1614: 1610: 1605: 1600: 1596: 1592: 1588: 1584: 1580: 1573: 1571: 1566: 1559: 1550: 1548: 1547:Philip Barrow 1544: 1543: 1538: 1534: 1533: 1528: 1518: 1514: 1511: 1500: 1496: 1491: 1481: 1477: 1473: 1469: 1467: 1461: 1452: 1450: 1446: 1442: 1437: 1433: 1428: 1426: 1421: 1419: 1414: 1412: 1408: 1404: 1400: 1396: 1392: 1388: 1384: 1380: 1370: 1368: 1363: 1359: 1343: 1340: 1337: 1334: 1331: 1328: 1325: 1322: 1321: 1320: 1317: 1309: 1305: 1301: 1300: 1296: 1294: 1289: 1288:antipsychotic 1285: 1281: 1277: 1273: 1262: 1259: 1258:sleep hygiene 1248: 1244: 1241: 1236: 1232: 1220: 1216: 1213: 1209: 1205: 1202: 1198: 1194: 1191: 1188: 1184: 1181: 1178: 1174: 1170: 1166: 1163: 1162: 1161: 1159: 1149: 1145: 1133: 1130: 1127: 1124: 1121: 1118: 1115: 1112: 1111: 1110: 1107: 1103: 1094: 1092: 1088: 1083: 1073: 1071: 1066: 1064: 1060: 1056: 1052: 1048: 1044: 1033: 1031: 1025: 1023: 1014: 1011: 1007: 1003: 998: 996: 992: 988: 984: 975: 972: 968: 963: 961: 951: 949: 945: 940: 935: 930: 928: 924: 920: 916: 912: 905:Animal models 902: 891: 886: 882: 879: 876: 873: 870: 866: 862: 858: 856: 855:heart failure 852: 851:heart attacks 848: 845: 843: 839: 837: 833: 829: 826: 824:complications 823: 820: 818: 814: 810: 806: 805: 803: 799: 795: 792: 790: 787: 784: 780: 777: 774: 770: 766: 765: 763: 758: 755: 753: 749: 748:dopaminergics 745: 741: 737: 733: 732: 730: 725: 722: 719: 716: 713: 712: 710: 707: 706: 705: 699: 695: 690: 679: 675: 673: 669: 666: 663: 660: 656: 653: 649: 645: 641: 639: 635: 632: 631: 630: 622: 620: 614: 601: 598: 595: 592: 588: 585: 584: 581: 578: 575: 571: 567: 566:Mood lability 564: 561: 557: 553: 550: 547: 543: 539: 535: 532: 529: 526: 523: 519: 515: 511: 508: 505: 504:tangentiality 501: 500:perseveration 497: 493: 489: 485: 482: 479: 476: 473: 468: 464: 460: 456: 452: 449: 446: 442: 438: 435: 434: 433: 431: 426: 413: 410: 407: 403: 400: 397: 396: 395: 393: 389: 385: 380: 378: 374: 364: 362: 358: 354: 350: 346: 341: 339: 335: 331: 327: 323: 320: 315: 309: 307: 303: 299: 295: 291: 287: 282: 280: 276: 275:schizophrenia 272: 268: 264: 260: 256: 252: 248: 244: 239: 237: 233: 229: 225: 221: 217: 213: 212:physiological 209: 205: 196: 194: 190: 186: 182: 179: 176: 174: 170: 167: 163: 159: 155: 152: 150: 146: 142: 138: 134: 130: 126: 122: 118: 114: 111: 107: 106:mood lability 103: 99: 95: 91: 87: 83: 79: 76: 74: 70: 67: 63: 59: 55: 52: 50: 46: 41: 33: 19: 8572:Folie à deux 8497:Intoxication 8478:substances, 8476:Psychoactive 8395:Night terror 8212:Dissociative 8176:Panic attack 8021: 7728:Tic disorder 7423: 7412: 7401: 7377: 7366: 7351: 7336: 7296: 7277: 7258: 7221: 7217: 7207: 7175:(1): 27–32. 7172: 7168: 7158: 7147:. Retrieved 7137: 7132: 7125: 7113: 7108: 7089: 7083: 7072:. Retrieved 7039: 7035: 7025: 6992: 6988: 6982: 6960:(3): 181–8. 6957: 6953: 6947: 6922: 6918: 6912: 6885: 6881: 6871: 6863:the original 6857: 6810: 6806: 6796: 6784:. Retrieved 6769: 6757:. Retrieved 6742: 6699: 6695: 6685: 6673:. Retrieved 6669: 6623: 6619: 6613: 6589:(1): 19–26. 6586: 6582: 6572: 6537: 6533: 6523: 6488: 6484: 6474: 6439: 6435: 6387: 6383: 6373: 6330: 6326: 6316: 6281: 6277: 6229: 6225: 6168: 6164: 6106: 6102: 6092: 6065: 6059: 6024: 6020: 5973: 5927: 5923: 5913: 5868: 5815: 5811: 5763: 5759: 5749: 5714: 5708: 5678:(2): 105–9. 5675: 5671: 5665: 5632: 5628: 5622: 5587: 5583: 5573: 5536: 5532: 5522: 5487: 5483: 5473: 5440: 5436: 5429: 5402: 5398: 5350: 5346: 5336: 5309: 5305: 5295: 5252: 5248: 5199: 5195: 5185: 5174:. Retrieved 5154: 5147: 5132: 5087: 5083: 5057:. Retrieved 5048: 5039: 4996: 4992: 4928: 4924: 4900:. Retrieved 4891: 4882: 4849: 4845: 4839: 4796: 4792: 4781: 4748: 4744: 4698: 4694: 4670:. 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