Call the Psychiatrist! - Study about Delirium in the context of liaison psychiatry

Abstract

Introduction Delirium is characterized as a short-term consciousness and cognition disturbance which tends to fluctuate during the course of the day. It is a common and serious problem, mainly in hospitalized older adults, potentially avoidable and often poorly recognized. Objectives We propose an analysis on the theme through a work that evaluates the requests for psychiatric consultation made in a district hospital in Portugal during the course of 12 months. Methods We identified all patients on the requests for psychiatric consultation and obtained a demographic, clinical and consultation requests by medical specialties data and conducted statistical analysis using Excel. Results We identified 106 consultation requests, in which 41 cases were eventually diagnosed as delirium. Most (83%) were hyperactive delirium, 12% were hypoactive delirium and 5% were mixed delirium. Incidence was higher in males (59%) and in those aged between 66 and 80 years old (56.1%). Most consultation requests were made by Internal Medicine (46.3%), followed by General Surgery (26.8%), Pulmonology (14.6%), Orthopedics (9.8%) and Neurology (2.5%). Finally, we analyzed which symptoms mentioned in the request made physicians consider requesting a psychiatric evaluation. Approximately half of the cases (48.8%) reported psychomotor agitation, followed by temporal/spatial disorientation (41.5%) and aggressive behaviour (17.1%). Conclusions We highlight a still notorious lack of proper identification of delirium, resulting in symptoms being incorrectly interpreted as a psychiatric disorder. This may cause a delay in the adequate diagnosis and management of the condition, increasing the morbidity and mortality of patients. Disclosure No significant relationships.

Keywords

• delirium
• symptoms
• liaison psychiatry