title: Excited delirium: A psychiatric review.
abstract: The term 'excited delirium' (ED) is used to explain sudden and unexpected restraint-related deaths. Since the 1990s, ED has often been identified as the principal cause of death in restrained individuals, rather than the restraint procedure itself. Forensic pathologists and psychiatrists attach different meanings to the term delirium. For psychiatrists, delirium is a specific technical term, which implies a grave and potentially life-threatening underlying physical illness. If a patient dies during a bout of delirium, psychiatrists assume that there will be autopsy evidence to demonstrate the primary underlying organic cause. Conversely, pathologists appear to be using the term ED to refer to restraint-related deaths in either highly disturbed cocaine users or psychiatric patients in a state of extreme agitation. In these cases, there is no underlying physical disorder other than a terminal cardiac arrhythmia. As the term ED has different meanings for psychiatrists and for pathologists, it would be helpful for these two professional groups to develop a mutually agreed terminology.
authors.affiliation: Guy's, King's and St Thomas' School of Medicine, London, UK m.lipsedge@btconnect.com.
authors.forename: Maurice
authors.initials: M
authors.lastname: Lipsedge
mesh_terms: D003645:Death, Sudden / Q000209:etiology*; D003693:Delirium; D005260:Female; D006801:Humans; D008297:Male; D012149:Restraint, Physical / Q000009:adverse effects*; D009626:Terminology as Topic
keywords: Ambiguity of term; Excited Delirum; restraint-related deaths