Delirium phenomenology: What can we learn from the symptoms of delirium?

Gupta, Nitin; Jonghe, Jos de; Schieveld, Jan N. M.; Leonard, Maeve; Meagher, David

doi:10.1016/j.jpsychores.2008.05.020

Cited by 88 publications

(80 citation statements)

References 93 publications

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“…In spite of significant advancements in many aspects of delirium research, more effort is necessary to reach an agreement between the varying definitions in internationally recognized classification systems [97]. Also there is an unrgent need to clarify in a more detailed way the causation, pathophysiology, assessment, treatment, and prognosis of this syndrome in both the general hospital [98] and palliative care [99] as well as the relationship between phenomenology of the clinical subtypes and course. The need for further studies, especially double-blind, randomized, placebocontrolled trials, is also extremely recommended, for a better understanding of the management of delirium in all medical settings, [100] including palliative care.…”

Section: Discussionmentioning

confidence: 99%

Management of Delirium in Palliative Care: a Review

Grassi

Caraceni

Mitchell

et al. 2015

Curr Psychiatry Rep

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Delirium is a complex but common disorder in palliative care with a prevalence between 13 and 88 % but a particular frequency at the end of life (terminal delirium). By reviewing the most relevant studies (MEDLINE, EMBASE, PsycLit, PsycInfo, Cochrane Library), a correct assessment to make the diagnosis (e.g., DSM-5, delirium assessment tools), the identification of the possible etiological factors, and the application of multicomponent and integrated interventions were reported as the correct steps to effectively manage delirium in palliative care. In terms of medications, both conventional (e.g., haloperidol) and atypical antipsychotics (e.g., olanzapine, risperidone, quetiapine, aripiprazole) were shown to be equally effective in the treatment of delirium. No recommendation was possible in palliative care regarding the use of other drugs (e.g., α-2 receptors agonists, psychostimulants, cholinesterase inhibitors, melatonergic drugs). Non-pharmacological interventions (e.g., behavioral and educational) were also shown to be important in the management of delirium. More research is necessary to clarify how to more thoroughly manage delirium in palliative care.

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Section: Discussionmentioning

confidence: 99%

Management of Delirium in Palliative Care: a Review

Grassi

Caraceni

Mitchell

et al. 2015

Curr Psychiatry Rep

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“…To fully capture the character of the syndrome, which includes fluctuations in severity over a 24-hour period, phenomenological issues must be explored with longitudinal studies that assess clinical profile throughout the duration of an episode. The increased interest in longitudinal study of delirium has highlighted that the course of delirium is much less reversible than traditional concepts have emphasised and that a significant number of patients experience persistent symptoms that can progress to long-term cognitive impairment [10] although the relevance of factors such as variations in underlying aetiology, ageing, genetic factors and treatment settings in shaping illness course over time remains uncertain [11].…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

Meagher

Leonard

Donnelly³

et al. 2012

Journal of Psychosomatic Research

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104

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“…Though the central features of delirium such as disturbances of consciousness, attention, cognition, thought, and language are fairly consistent, its presentation can be highly variable with a wide range of associated non-cognitive symptoms that reflect the influence of particular etiologies, comorbidities, medical treatments, or individual vulnerabilities [1,2]. Delirium is independently associated with several adverse consequences such as functional decline, prolonged hospitalstays, increased rates of admission to long-term care, increased mortality, and increased costs of care [3,4].…”

Section: Introductionmentioning

confidence: 99%