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Delirium is a disorder that affects the functioning of thought. Ideas become erroneous, contrary to given evidence and the perception of reality is completely altered. Delirium is a psychological or psychiatric symptom of an organic disease (neurological diseases, intense fever ...psychosis, paranoia ...). It can be acute or chronic.


Delusions will differ according to the causes that are at their origin. They will not necessarily be recognized by a non-expert. They are often based on incoherent ideas, a recurring discourse: persecutory delusions, paranoia, erotomania ... and altered behavior. In psychiatry, various elements characterize delirium: the theme roughly coressponds to its contents: grandiosity, persecution, destruction ...; its mechanisms: erroneous interpretation of facts, hallucination, imagination ...; the degree to which the patient believes in his delirium; his criticism, ability to look at his delirium from outside; its effect, and emotional toll.


The diagnosis is made after a clinical examination that looks for a possible organic root cause of delirium such as acute intoxication or another neurological, metabolic (hypoglycemia), hormonal, or infectious cause. The cause may also be in the elderly a pain that they cannot verbalize or a symptom such as acute urinary retention or dehydration. In the absence of a somatic cause, the patient will be referred to a psychiatrist. The latter will make a diagnosis after several discussions with the patient.


Treatment will depend on the cause of delirium. The HCP should try to address the cause if it is of somatic origin and is susceptible to treatment. In case of sudden onset of delirium without organic or toxic cause, support is urgently and frequently manifested with the taking of oral or intramuscular (in case of refusal) antipsychotic, often olanzapine. Treatment should be continued along with psychiatric treatment. In the case of a chronic psychosis or delirium, a disease that is generally incurable, an antipsychotic neuroleptic treatment is often used to manage the symptoms. A regular psychological support is also put in place so that the person can verbalize their problems, understand the causes of their suffering and thus escape them.


Delusions by toxic origin can be prevented by halting the intake of involved substances. As for psychiatric delusions, there are no real ways to prevent the onset of delirium, the factors causing the natures being too varied. Antipsychotic treatments in patients suffering from chronic delusions can reduce the occurrence of acute delirium.

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