Hewer W, Förstl H
Zentralinstitut für Seelische Gesundheit, Mannheim.
Psychiatr Prax. 1994 Jul;21(4):131-8.
Delirium--a state of acute or subacute confusion--is a common organic mental syndrome occurring predominantly in old age. The disorder is highly prevalent in psychiatric institutions, in general hospitals and nursing homes. Patients affected by delirium carry an increased mortality-risk and will become dependent on nursing care in a high percentage. In this paper, diagnostic criteria, symptomatology, and pathogenesis of delirious states are reviewed. The wide variety of etiologic factors is illustrated by case histories. The present state of diagnostic and therapeutic management is discussed. A review of recent publications indicates that substantial advances in knowledge on epidemiology, operationalized diagnosis, risk factors, and course of delirium have been attained. There are, however, important aspects--e.g. the evaluation of prophylactic and therapeutic measures--which have been neglected. With regard to the high prevalence of delirium and the inderdisciplinary relevance of this syndrome scientific activities on this field should be increased as well as refreshment of knowledge of medical and nursing staff should be aimed at.
谵妄——一种急性或亚急性意识混乱状态——是一种常见的器质性精神综合征，主要发生于老年人群。该病症在精神病院、综合医院和疗养院中极为普遍。受谵妄影响的患者死亡风险增加，且很大比例的患者会依赖护理照料。本文对谵妄状态的诊断标准、症状学及发病机制进行了综述。通过病例史阐述了多种病因。讨论了诊断与治疗管理的现状。对近期出版物的回顾表明，在谵妄的流行病学、操作性诊断、危险因素及病程方面的知识已有显著进展。然而，一些重要方面，如预防性和治疗性措施的评估，却被忽视了。鉴于谵妄的高发病率以及该综合征的跨学科相关性，应加强该领域的科研活动，并致力于更新医护人员的知识。
