Post-traumatic Stress Disorder Following Acute Delirium

Bolton, Corey; Thilges, Sarah; Lane, Carissa; Lowe, Jacob; Mumby, Patricia

doi:10.1007/s10880-019-09689-1

Cited by 17 publications

(18 citation statements)

References 64 publications

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“…Qualitative research has reported on the experiential distress and resulting features of anxiety and depression that patients have after an in-patient episode of delirium (Whitehorne 2015). In particular, post-traumatic stress disorder (PTSD) is emerging as a recognised consequence of delirium and it has been suggested that it should be more routinely followed up, given its potential impact on patient recovery and quality of life (Teale 2013; Bolton 2019). However, many patients do not report their symptoms as they feel that the delirium experience is evidence of a severe mental illness associated with stigma (Kim 2017).…”

Section: Recoverymentioning

confidence: 99%

Delirium in the acute hospital setting: the role of psychiatry

Fitzgerald

Price

2020

BJPsych advances

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SUMMARY In this overview we discuss the role of psychiatry in managing delirium in acute hospital admissions. We briefly discuss the role psychiatry can offer in four main domains: (a) assessment; (b) management; (c) recovery; and (d) paradigm, education and research. In the assessment section we discuss accurately detecting delirium in the context of comorbid mixed neuropsychiatric syndromes, including depression and dementia, and the clinical importance of delirium subtyping. The management section briefly outlines pharmacological and non-pharmacological approaches to delirium and their evidence-based rationale. The recovery section focuses on the effect delirium can have on cognitive decline, mental health and long-term health, including functional outcome and need for institutional care after hospital discharge. Finally, we outline the role of psychiatry in delirium research and education. We hope that this article will encourage clinicians to reflect on their current practice and consider holistic and evidence-based care for this vulnerable population in the acute hospital setting.

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Section: Recoverymentioning

confidence: 99%

Delirium in the acute hospital setting: the role of psychiatry

Fitzgerald

Price

2020

BJPsych advances

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“…There is almost no systematic research on PTSD following delirium, but Bolton et al (2020) cite a series of case studies attesting to the feasibility of this phenomenon (i.e., PTSD following delirium). Bolton et al (2020) further distinguish the occurrence of this phenomenon in inpatient unites vs. intensive care units, and younger and older adults, and also discuss possible risk and resilience factors, and point to some innovative directions for intervention.…”

mentioning

confidence: 99%

“…Delirium pertains to disturbance in attention, awareness, and other cognitive factors, with a rapid onset and fluctuating course. According to Bolton et al (2020), the prevalence of delirium ranges between 14 and 24%. There is almost no systematic research on PTSD following delirium, but Bolton et al (2020) cite a series of case studies attesting to the feasibility of this phenomenon (i.e., PTSD following delirium).…”

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confidence: 99%

Interdisciplinarity and Integration: An Introduction to the Special Issue on Psychopathology in Medical Settings

Shahar

2020

J Clin Psychol Med Settings

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As the world views, incredulously, the calamitous consequences of the COVID-19 pandemic, the inseparable connections between body and mind become more and more apparent, even for the heretics (i.e., biological determinists). Such realizations also bolster the understanding of the close link between medical conditions and psychopathology. Launched prior to the COVID-19 epidemic, this special issue sets out to illuminate the prevalence, course, etiology, and responses to a myriad of psychopathological conditions in medical conditions. The 13 articles in this special issue address a variety of medical conditions (chronic illness and chronic pain, Pica, cancer, acute delirium, factitious disorders, functional neurological symptoms, sleep disorders, fetal conditions), mental disorders (depression, anxiety, suicidality, eating disorders, personality disorders, PTSD), medical settings (primary care vs. specialty clinics), and developmental levels (children, adolescents, and adults). The overarching theme emanating from reading these articles is that clinical-health psychology, or clinical psychology in medical settings, is an ever-needed field of inquiry, epitomizing interdisciplinarity and science/practice integration.

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“…Approximately one-third of patients who experience delirium will have signs and symptoms of posttraumatic stress disorder (PTSD) 2 weeks following recovery from the delirium, and the likelihood of developing PTSD is associated with delirium severity. 13 Families are similarly devastated to witness their loved ones behaving erratically or even violently. And even staff members suffer not only because of the stress and all-consuming nature of the care but also when confused patients mistakenly see attempts to provide care as a threat.…”

mentioning

confidence: 99%

Evaluation and Management of Delirium

Ryan

Kimchi

2021

Semin Neurol

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Delirium, sometimes referred to as encephalopathy, is an acute confusional state that is both common in hospitalized patients and associated with poor outcomes. For patients, families, and caregivers, delirium can be a traumatic experience. While delirium is one of the most common diagnoses encountered by the consulting neurologist, the majority of the time it will have been previously unrecognized as such by the care team. Neurologic syndromes such as dementia or aphasia can either be misdiagnosed as delirium or may coexist with it, necessitating careful neurologic assessment. Once the diagnosis of delirium has been established, a careful evaluation for predisposing and precipitating factors can help uncover modifiable contributors, which should be addressed as part of a multicomponent, primarily nonpharmacologic intervention. Importantly, delirium management, which begins with comprehensive prevention, should emphasize the humanity of the delirious patient and the challenges of caring for this vulnerable population. When considered, delirium represents an important opportunity for the neurologist to substantially enhance patient care.

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Post-traumatic Stress Disorder Following Acute Delirium

Cited by 17 publications

References 64 publications

Delirium in the acute hospital setting: the role of psychiatry

Delirium in the acute hospital setting: the role of psychiatry

Interdisciplinarity and Integration: An Introduction to the Special Issue on Psychopathology in Medical Settings

Evaluation and Management of Delirium

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