Compare and contrast delirium with brief psychotic disorder. For this discussion you will need to place particular emphasis on how comprehensive assessment could help us to arrive at the correct diagnosis for adult/ geriatric patient.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Delirium and Brief Psychotic Disorder (BPD) are two distinct clinical conditions that can present with similar symptoms but have different etiologies and treatment approaches. Comprehensive assessment plays a crucial role in accurately diagnosing these conditions, especially in adult and geriatric patients. This response will compare and contrast delirium and BPD, highlighting the importance of comprehensive assessment in arriving at the correct diagnosis.
Delirium is an acute confusional state characterized by disturbances in attention, awareness, and cognition. It is typically caused by an underlying medical condition or substance intoxication/withdrawal and is reversible once the underlying cause is treated. On the other hand, BPD is a brief episode of psychosis, lasting from one day to one month, characterized by the presence of positive symptoms such as hallucinations, delusions, disorganized thinking, or grossly disorganized or catatonic behavior. BPD is not attributable to a medical condition or substance use and is usually self-limited.
To differentiate between delirium and BPD, comprehensive assessment is crucial. The assessment should include a thorough medical and psychiatric history, physical examination, mental status examination, and laboratory investigations. In the case of delirium, the focus should be on identifying potential underlying medical conditions, such as infections, metabolic disturbances, medication side effects, or organ failure. Laboratory tests, including complete blood count, electrolytes, liver and kidney function tests, thyroid function, and toxicology screens, can help identify these underlying causes (Reid et al., 2019).
In contrast, the assessment for BPD should aim to rule out medical causes and substance use. This can be achieved by reviewing the patient’s history, conducting a comprehensive physical examination, and utilizing laboratory tests when necessary. Substance-induced psychosis can be ruled out by performing urine toxicology screens and assessing for the presence of substances known to cause psychosis (Dixon, 2019).
The mental status examination is an essential component of the assessment for both delirium and BPD. In delirium, there are often fluctuations in attention and awareness, disorientation, memory impairment, and perceptual disturbances. The presence of physical signs, such as tremors, asterixis, or autonomic dysregulation, may also be observed. In BPD, the mental status examination may reveal the presence of well-formed delusions or hallucinations, disorganized thought processes, and abnormal behavior. The absence of clouding of consciousness, fluctuations in symptoms, or physical signs of medical illness helps differentiate BPD from delirium (Drevets & Fava, 2019).
In summary, comprehensive assessment is crucial for distinguishing between delirium and BPD in adult and geriatric patients. Delirium is characterized by an acute confusional state resulting from an underlying medical condition or substance use, while BPD is a brief episode of psychosis not attributable to these causes. By carefully evaluating the patient’s medical history, conducting a physical examination, and employing appropriate laboratory investigations, clinicians can arrive at an accurate diagnosis and provide appropriate treatment.
References:
Dixon, L. B. (2019). Substance use and psychosis: Epidemiology, neurobiology, and treatment. Journal of Clinical Psychiatry, 80(3), 18com12229.
Drevets, W. C., & Fava, M. (2019). Psychotic major depression: overview of burden, diagnosis, and treatment. The Journal of Clinical Psychiatry, 80(3), 18com12448.
Reid, M. A., Mason, M., Hargrave, R., & McCluskey, P. (2019). Delirium: An update on diagnosis, treatment and prevention. Australian Family Physician, 48(5), 317-322.