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**10** 

*Turkey* 

**A Review of the Etiology Delirium** 

*1Cerrahpasa Medical School, Department of Psychiatry 2Department of Child and Adolescent Psychiatry* 

Nese Kocabasoglu1, Gul Karacetin2, Reha Bayar1 and Turkay Demir3

Delirium, also called as organic brain syndrome, acute brain syndrome, acute brain failure, acute confusional episode and reversible or masked dementia, as a concept, stretches back to the age of Hypocrates (Burns et al., 2004). Delirium is described as a condition characterized by a disturbance of consciousness with reduced ability to focus, sustain, or shift attention according to the Diagnostic and Statistical Classification of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (American Psychiatric Association, 2000). Also, delirium involves a change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia (American Psychiatric Association, 2000). In addition to these, impairment in the brain's ability to integrate perceptions correctly, coupled with memory deficits and confusion may result in psychotic symptoms in delirium. Hallucinations (especially visual and tactile), delusions, paranoia, illusions, and bizarre behavior are the commonly

Delirium is associated with longer hospital stay, poorer functional outcome, and cognitive decline in addition to an elevated morbidity and mortality. Despite these adverse outcomes, delirium recognition rates are low (12–43%) and its management remains inadequate in up to 80% of patients (Morrison et al., 2003). These findings suggest lack of preventive and screening activities, missed diagnoses, and inappropriate management of diagnosed

The prevalence of delirium varies with the population that is being studied (Fong et al., 2009). Delirium is a relatively common disorder, especially in older people with physical illness (Saxena & Lawley, 2009). Community rates of delirium are reported to vary from 0.4% to 2% (Saxena & Lawley, 2009, Fong et al., 2009). In general hospital setting prevalence of delirium has been reported to range from 11% to 33% on admission (Lindesay et al., 2002) and its incidence during hospital stay ranges between 3% and 56% (Inouye, 2006; Michaud L

encountered psychotic symptoms in delirium (Leigh, 2008).

delirium (Michaud et al., 2007).

**2. Epidemiology 2.1 Prevalence** 

et al., 2007).

**1. Introduction** 

*3Cerrahpasa Medical School, Department of Child and Adolescent Psychiatry* 

