Agitation is defined as a state of increased psychomotor activity, often accompanied by increased volume and rate of speech, as well as labile and inappropriate affect.

Confusion is a layman's term; it is not a well-defined mental state. Webster's Dictionary (3rd edition, 1986) defines the 'state of being confused' as one that has a 'lack of certainty, orderly thought, or power to distinguish, choose, or act decisively.' Confusion with an acute onset has been called delirium, acute confusional state, acute brain syndrome, acute cerebral insufficiency, or ICU psychosis. For the purpose of this chapter, we prefer the terms delirium and confusional state. The hallmark of delirium is fluctuation or clouding of consciousness, i.e. a reduced clarity of awareness of the environment. Delirium can present with agitation (hyperactive subtype), with decreased psychomotor activity or somnolence (hypoactive subtype), or with a mixture of hyper- and hypoactivity. Alterations of three cognitive domains (attention, orientation, and memory) contribute primarily to the clinical presentation of delirium.

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