Psychiatric Complications of Physical Disorders Flashcards
what is delirium
acute confusion with transient global disturbance
usually an underlying medical/drug-related cause
what are risk factors for delirium
age (elderly patients)
cognitive deficit dementia
existing sensory deficits i.e. deafness, blindness
previous episode
perioperative i.e. long surgery, emergency surgery
immobility
new environment
stress and social isolation
what are Sx of delirium
changes in consciousness
- clouding, drowsiness, stupor, coma
disorientation
impaired concentration/memory/thinking
impaired cognition
hallucinations = visual or auditory
psychomotor disturbance = agitation or retardation
emotional disturbance = fear, anxiety, aggression, apathy, irritability
insomnia = sundowning
what is sundowning
nocturnal worsening of Sx
what are common causes of delirium
Drugs Withdrawal Metabolic Infections Head Trauma Epilepsy Neoplastic diseases Vascular Disorders
what drugs can lead to delirium
anticholinergic anticonvulsants anti-parkinsonian steroids opiates sedative
alcohol
illicit drugs
what vascular disorders can lead to delirium
TIA Thrombosis Embolism Migraine MI Cardiac failure
Ix of delirium
Hx and full physical examination
Formal cognitive tests (MMSE, CAM, ACE-R, MoCA)
Urine Analysis FBC, U&Es, LFTs, CRP Thyroid Function Tests Blood Glucose B12 and folate Be guided by emerging underling cause
Mx of delirium
Identify and treat the cause
Manage environment and provide support
Prescribe
Review
what are non-drug measure that you can take to prevent/treat delirium
quiet side-room constant orientation well lit encourage minimal staff changes removes unnecessary equipment
what is the most common neuropsychiatric complication of stroke
post stroke depression
