Oldham et al.
1
propose a new model of delirium diagnosis in an article entitled “Refining delirium:
a trans-theoretical model of delirium disorder with preliminary neurophysiological
subtypes.” In this bold and provocative article, the authors propose a model for delirium
that distinguishes the phenotype—the core attentional and arousal symptoms defined
in the current diagnostic systems—from a delirium “disorder,” which they suggest should
include consideration of specific precipitants of the syndrome, the protective baseline
cognitive features, and the resultant neuropathological injury. They argue that this
view is transtheoretical. Rather than advocating for one unifying model underlying
the syndrome of delirium, this view allows for an interactive framework that starts
with identifying precipitants as well as resilience and requires postulation as to
neurophysiology and pathology.To read this article in full you will need to make a payment
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References
- Refining delirium: a trans-theoretical model of delirium disorder with preliminary neurophysiological subtypes.Am J Geriatr Psychiatry. 2018; 26: 913-924
- Multifocal, diffuse, and metabolic brain diseases causing delirium, stupor and coma.in: Plum and Posner's Diagnosis of Stupor and Coma—Fourth Edition. Oxford University Press, New York2007: 181-183
- Outcome of delirium in critically ill patients: systematic review and meta-analysis.BMJ. 2015; 350: h2538
- Delirium in elderly people.Lancet. 2014; 383: 911-922
- Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients.Intensive Care Med. 2008; 34: 1907-1915
Article info
Publication history
Published online: June 15, 2018
Accepted:
May 16,
2018
Received:
May 15,
2018
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
