Discuss the DSM-5 diagnostic criteria and treatment options for delirium. Include a comparison of symptom onset and length for younger and older adults
What will be an ideal response?
The DSM-5 diagnostic criteria for delirium include a disturbance of consciousness and decreased ability to focus attention. Symptoms are accompanied by a change in cognitive functioning or development of delusions or hallucinations not accounted for by dementia or any other previously existing condition. Delirium typically starts suddenly and fluctuates over the course of the day, and there is usually evidence from the patient’s history or medical tests that the delirium is caused by a medical condition.
The onset of delirium is sudden, typically within hours or days, but it can be slow and progressive among older adults. Symptoms of delirium can persist for months in older patients, in contrast to young adults, where they typically disappear after only a short time.
As a first step towards treatment, screening for known risk factors is necessary. In general, treatment strategies include medication, environmental changes, and support for both the patient and family. Low-dose antipsychotic medications can help keep the patient safe and reduce symptoms. When delirium is due to withdrawal of alcohol or other sedatives, short-acting benzodiazepines may be used.
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