View source for Delirium

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'''Delirium''' (also known as '''acute [[confusion]]''')<ref name="SendelbachGuthrie2009">{{cite journal|last1=Sendelbach|first1=Sue|last2=Guthrie|first2=Patty Finch|last3=Schoenfelder|first3=Deborah Perry|title=Acute Confusion/Delirium|journal=Journal of Gerontological Nursing|volume=35|issue=11|year=2009|pages=11–18|issn=0098-9134|doi=10.3928/00989134-20090930-01}}</ref> is medically recognized as a physiological disturbance of awareness that is accompanied by a change in baseline cognition which cannot be better explained by a preexisting or evolving neurocognitive disorder.<ref name="ICD-11-Delirium">{{cite journal|title=Delirium|journal=International statistical classification of diseases and related health problems (11th ed.)|year=2022|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/897917531 | access-date=20 May 2022}}</ref> The disturbance in awareness is manifested by a [[focus suppression|reduced ability to direct, focus, sustain, and shift attention]] and the accompanying cognitive change in at least one other area may include [[memory suppression|memory and learning (particularly recent memory)]], disorientation (particularly to [[time distortion|time]] and [[spatial disorientation|place]]), [[language depression|alteration in language]], or [[visual distortions|perceptual distortions]] or a [[physical alterations|perceptual-motor disturbance]]. The perceptual disturbances accompanying delirium include [[Peripheral information misinterpretation|misinterpretations]], [[internal hallucination|illusions]], or [[external hallucination|hallucinations]]; these disturbances are typically visual but may occur in other modalities as well, and range from simple and uniform to highly complex. An individual with delirium may also exhibit emotional disturbances, such as [[anxiety]], fear, [[depression]], [[irritability]], anger, [[cognitive euphoria|euphoria]], and apathy with rapid and unpredictable shifts from one emotional state to another.<ref name="DSM5Delirium">{{cite journal|title=Neurocognitive Disorders|journal=Diagnostic and statistical manual of mental disorders (5th ed.)|year=2013|pages=596-602|doi=10.1176/appi.books.9780890425596.dsm17}}</ref>

This disturbance develops over a short period of time, usually hours to a few days, and tends to fluctuate during the course of the day, often with worsening in the evening and night when external orienting stimuli decrease. It has been proposed that a core criterion for delirium is a disturbance in the sleep-wake cycle. Normal attention/arousal, delirium, and coma lie on a continuum, with coma defined as the lack of any response to verbal stimuli.<ref name="DSM5Delirium" /> 

Delirium may present itself in three distinct forms. These are referred to in the scientific literature as hyperactive, hypoactive, or mixed forms.<ref name="FongTulebaev2009">{{cite journal|last1=Fong|first1=Tamara G.|last2=Tulebaev|first2=Samir R.|last3=Inouye|first3=Sharon K.|title=Delirium in elderly adults: diagnosis, prevention and treatment|journal=Nature Reviews Neurology|volume=5|issue=4|year=2009|pages=210–220|issn=1759-4758|doi=10.1038/nrneurol.2009.24}}</ref> In its hyperactive form, it is manifested as severe confusion and disorientation, with a sudden onset and a fluctuating intensity. In its hypoactive (i.e. underactive) form, it is manifested by an equally sudden withdrawal from interaction with the outside world accompanied by symptoms such as drowsiness and general inactivity.<ref name="HoskerWard2017">{{cite journal|last1=Hosker|first1=Christian|last2=Ward|first2=David|title=Hypoactive delirium|journal=BMJ|year=2017|pages=j2047|issn=0959-8138|doi=10.1136/bmj.j2047}}</ref> Delirium may also occur in a mixed type in which one can fluctuate between both hyper and hypoactive periods. 

Delirium is most commonly induced under the influence of [[dosage#heavy|heavy]] [[dosage|dosages]] of [[deliriant]] compounds, such as [[DPH]],<ref name="Serio2004">{{cite journal|last1=Serio|first1=Ryan N|title=Acute Delirium Associated with Combined Diphenhydramine and Linezolid Use|journal=Annals of Pharmacotherapy|volume=38|issue=1|year=2004|pages=62–65|issn=1060-0280|doi=10.1345/aph.1D018}}</ref> [[datura]],<ref>{{cite journal | vauthors=((Hanna, J. P.)), ((Schmidley, J. W.)), ((Braselton, W. E.)) | journal=Clinical Neuropharmacology | title=Datura Delirium: | volume=15 | issue=2 | pages=109–113 | date= April 1992 | url=http://journals.lww.com/00002826-199204000-00004 | issn=0362-5664 | doi=10.1097/00002826-199204000-00004}}</ref> and [[benzydamine]]. However, it can also occur as a result of an extremely wide range of health problems such as urinary tract infections,<ref name="BalogunPhilbrick2014">{{cite journal|last1=Balogun|first1=Seki A.|last2=Philbrick|first2=John T.|title=Delirium, a Symptom of UTI in the Elderly: Fact or Fable? A Systematic Review*|journal=Canadian Geriatrics Journal|volume=17|issue=1|year=2014|issn=1925-8348|doi=10.5770/cgj.17.90}}</ref> influenza,<ref name="ManjunathaMath2011">{{cite journal|last1=Manjunatha|first1=Narayana|last2=Math|first2=SureshBada|last3=Kulkarni|first3=GirishBaburao|last4=Chaturvedi|first4=SantoshKumar|title=The neuropsychiatric aspects of influenza/swine flu: A selective review|journal=Industrial Psychiatry Journal|volume=20|issue=2|year=2011|pages=83|issn=0972-6748|doi=10.4103/0972-6748.102479}}</ref> and alzheimer’s.<ref>{{cite journal | vauthors=((Lerner, A. J.)), ((Hedera, P.)), ((Koss, E.)), ((Stuckey, J.)), ((Friedland, R. P.)) | journal=Alzheimer Disease & Associated Disorders | title=Delirium in Alzheimer Disease: | volume=11 | issue=1 | pages=16–20 | date= March 1997 | url=http://journals.lww.com/00002093-199703000-00004 | issn=0893-0341 | doi=10.1097/00002093-199703000-00004}}</ref>
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===Psychoactive substances===
Compounds within our [[psychoactive substance index]] which may cause this effect include:
{{#ask:[[Category:Psychoactive substance]][[Effect::Delirium]]|format=ul|Columns=1}}
===Experience reports===
Annectdotal reports which describe this effect with our [[experience index]] include:
{{#ask:[[Category:Experience]][[Effect::Delirium]]|format=ul|Columns=2}}
===See also===
*[[Responsible use]]
*[[Psychosis]]
*[[Deliriants#Subjective_effects|Deliriants - Subjective effects]]
*[[Dissociatives#Subjective_effects|Dissociatives - Subjective effects]]
*[[Psychedelics#Subjective_effects|Psychedelics - Subjective effects]]
===External links===
*[https://en.wikipedia.org/wiki/Delirium Delirium (Wikipedia)]
*[https://www.youtube.com/watch?v=qmMYsVaZ0zo Delirium explanation (YouTube)]
===References===
{{reflist}}
[[Category:Cognitive]] 
[[Category:Depression]] 
[[Category:Effect]]