Epidemiology

Delirium is a very common disorder, accepted as an inevitable concomitant of serious acute illness in children or adults. The probable lifetime risk is 100 per cent, in that everyone has the potential to suffer delirium symptoms with severe physical illness. It is more frequent among people with brain damage and in conditions of low sensory input (such as poor lighting and isolation).

Therefore medical attention is focused on those cases where there is no obvious cause, where there are troublesome features such as disturbed behaviour or psychotic symptoms, or where the diagnosis is uncertain. Less conspicuous cases are usually not recognized as suffering from a diagnosable psychiatric disorder. Surveys also find many patients with transient, subthreshold cognitive disturbances on neuropsychological testing that do not satisfy the full criteria for delirium. For example, it has been reported that six of 70 patients had DSM-III delirium on the second or third day after coronary artery bypass grafting; a larger number had milder disturbances, which did not meet full DSM criteria. Patients who developed delirium had worse cognitive function and worse cardiac function preoperatively. (2)

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