Respond in a positive way to your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned.
NOTE: Bellow is attached the document with my assigned disorder
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Delirium is an acute intermittent neuropsychiatric condition generally reversible but serious condition that occurs in all age groups but high risk in the elderly(Gabbard, 2014). It ultimately represents the decompensation of brain function as a result of one or more pathophysiological processes(Fong, 2009). Delirium is linked with a variety of negative effects, leading to extended hospital stay, institutional care demands, poor functioning and high medical costs(Fong, 2009).Due to these negative consequences it is essential to prevent, detect and treat delirium as early as possible.
Diagnostic criteria
Accordint to the DSM-5, diagnostic criteria for delirium is :
A. A disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift attention) and awareness (reduced orientation to the environment) (American Psychiatric Association, 2013).
B.The disturbance develops over a short period of time (usually hours to a few days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day(American Psychiatric Association, 2013).
C.An additional disturbance in cognition (e.g., memory deficit, disorientation, language, visuospatial ability, or perception) (American Psychiatric Association, 2013).
D.The disturbances in Criteria A and C are not better explained by another preexisting, established, or evolving neurocognitive disorder and do not occur in the context of a severely reduced level of arousal, such as coma(American Psychiatric Association, 2013).
E.There is evidence from the history, physical examination, or laboratory findings that the disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal( due to a drug of abuse or to a medication), or exposure to a toxin, or is due to multiple etiologies(American Psychiatric Association, 2013).
Psychotherapy and Psychopharmacologic Treatment
Delirium is a medical emergency that involves proper diagnosis, recognition of the cause and management of symptoms.The first-line treatment is to identify and address pre- disposing factors, provide supportive care, and manage symptoms through behavioral strategies(Fong, 2009). Treatment is geared toward symptom management and patient centered.Medications are used to control agitation and reverse hyperactive delirium (Fong, 2009).Medication treatment includes antipsychotics such as haloperidol and chlorpromazine.The goals of these pharmacological agents is to reduce agitation and address other symptoms associated with hyperactive deliria (Gabbard, 2014).Non-pharmacological treatment of delirium stresses the removal or reduction of medical, sensory and environmental factors that can lead to delirium,such as modifying sensory deficits in order to improve engagement with the environment, particularly when coupled with sufficient intellectual stimulation during wake-up hours (Gabbard, 2014).Lastly, immoboizing devices can be used but should be reserved when harm to self and others is immenent, and should be short and behaviroal targeted(Gabbard, 2014).
Benefits and Risks of Therapy
When choosing any drug, attention should always be given to the possible advantages,
dangers and pressures of each medicine, as well as to the patient and family care priorities (Grover, 2018).The use of antipsychotics have many adverse effects that include sedation, wiegth gain, changes in appetite, cardiac effects(such as QT prolongation), neaurological effects, falls and long term need for use that is inappropriate but in many cases it is the best course of action.According to Fong (2009), studies some beneficial roles of antipsychotics such as lowering severity of delirum, reducing harm to self and others are the main reasons why these agents are used.However, Grover (2018), emphasizes that antipsychotics for the treatment of delirium in adult inpatients did not improve patient outcomes, with little evidence of neurologic harms but a tendency for more frequent potentially harmful cardiac effects.
Reference
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Fong, T. G., Tulebaev, S. R., & Inouye, S. K. (2009). Delirium in elderly adults: diagnosis, prevention and treatment. Nature reviews. Neurology, 5(4), 210220. doi:10.1038/nrneurol.2009.24 Mayo Clinic. 2018. Delirium.
Gabbard, G.O.(2014). Gabbards treatment of psychiatric disorders(5th ed.).Washington, DC: American Psychiatric Publications
Grover, S., & Avasthi, A. (2018). Clinical Practice Guidelines for Management of Delirium in Elderly. Indian journal of psychiatry, 60(Suppl 3), S329S340. https://doi.org/10.4103/0019-5545.224473
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