[Delirium? Admission to the general hospital, rather than a psychiatric hospital].
Delirium is often not recognized either by psychiatrists or by other physicians. In two men, aged 78 and 70 years, a diagnosis of delirium was not recognized at admission. The first patient had Alzheimer's disease with superimposed delirium caused by pulmonary embolism, which led to cardiopulmonary arrest during his stay in a psychiatric hospital. The other patient had a delirium due to multiple somatic causes (carbon monoxide poisoning with cerebral damage, pulmonary infection, heart attack) which was not recognized leading to an early discharge from the general hospital. The first patient died later on because of complications of a pneumonia and the other patient was transferred to a nursing home on a maintenance dose of haloperidol. Since delirium is a symptom of a medical disorder, delirious patients should be referred primarily to a general hospital.
van Waarde
J A
JA
Mentrum GGZ Amsterdam.
van der Mast
R C
RC
D000368:Aged; D002249:Carbon Monoxide Poisoning / Q000150:complications / Q000175:diagnosis*; D003693:Delirium / Q000209:etiology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D006323:Heart Arrest / Q000209:etiology; D006760:Hospitalization; D006769:Hospitals, General; D006778:Hospitals, Psychiatric; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*; D012017:Referral and Consultation / Q000592:standards