Psychiatric Approach to Delirium
Delirium is an acute change in a person’s sensorium (the perception of one’s environment or understanding of one’s situation). It can include confusion about their orientation, cognition or mental thinking.
With hyperactive delirium, a patient can become aggressive, violent and agitated with those around them. A patient experiencing delirium can have hallucinations and hear things, they can become paranoid, and they are overall confused. A family or non-psychiatric medical staff might be concerned that the patient is experiencing something like schizophrenia.
Hyperactive delirium symptoms in patients:
Waxing and waning —it comes and goes
Issues with concentration
Pulling out medical lines
Yelling profanities
Throwing things
Agitated
Responding to things in the room that aren’t there
Not acting like themselves
Hypoactive delirium is much more common than hyperactive delirium (based on research studies), but it is often missed because the presentation is much less dramatic. People with hypoactive delirium are confused and disoriented, but they are not expressing their confusion verbally or physically.
Hypoactive delirium symptoms:
Slower movement
Softer speech
Slower responses
Withdrawn
Not eating as much
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