Journal of Psychiatry

Role of Delirium in Neurocognitive Impairment and its Diagnosis

George Rosenberg^* Departments of Psychiatry and Neurology, University of Melbourne, Melbourne, Australia
^*Correspondence: George Rosenberg, Departments of Psychiatry and Neurology, University of Melbourne, Melbourne, Australia, Email:

Received: 03-Apr-2023, Manuscript No. JOP-23-21143; Editor assigned: 06-Apr-2023, Pre QC No. JOP-23-21143(PQ); Reviewed: 20-Apr-2023, QC No. JOP-23-21143; Revised: 27-Apr-2023, Manuscript No. JOP-23-21143(R); Published: 04-May-2023, DOI: 10.35248/2378-5756.23.26.581

Description

A neurocognitive disorder is a term that describes decreased mental function due to a medical disease other than a psychiatric illness. It can affect cognitive abilities such as learning, memory, perception, and problem solving. There are 3 subcategories of neurocognitive disorders i.e., delirium, mild neurocognitive disorder, and major neurocognitive disorder (previously known as dementia). They are usually caused by an underlying brain pathology or damage. The symptoms of delirium in neurocognitive disorders are similar to those of delirium in general.

• Reduced awareness of surroundings, such as trouble focusing, being easily distracted, or being withdrawn.

• Poor thinking skills, such as poor memory, trouble with speech or language, or rambling or nonsense speech.

• Changes in sleep habits, such as excessive sleepiness or a switched night-day sleep-wake cycle.

The main exposure was experiencing delirium at any time while in the intensive care unit. The validated Intensive Care Delirium Screening was used to measure delirium. As there are presently no published validated coding systems for trauma- and stressorrelated and neurocognitive diseases, only the neuropsychiatrist and psychiatrist created by their own. The International Classification of Diseases (ICD 9/10) codes for trauma- and stressor-related and neurocognitive disorders were identified after the two physicians separately assessed all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) codes as well as earlier studies that reported these illnesses. In order to identify those who had been given a diagnosis for any of the four neuropsychiatric diseases, neuropsychiatric illnesses were looked at collectively and then individually.

Some of the possible medical conditions that can trigger delirium in neurocognitive disorders are urinary tract infections, dehydration, electrolyte imbalances, certain medications, infection, surgery, or alcohol or drug use or withdrawal. It is a serious and sudden change in mental abilities that causes confusion, reduced awareness, poor thinking skills, and behavior and emotional changes. It affects the brain by interfering with its normal functioning and causing inflammation or imbalance. It can be treated by finding and addressing the underlying cause. Some other preventive measures are it promotes good sleep hygiene by reducing noise and distractions, mobilizing patient’s early and encouraging physical activity. Make sure that patients have adequate hearing and vision aids. Managing pain adequately with appropriate analgesics and good hydration and nutrition. Monitoring bowel and bladder function and treating constipation or urinary retention. Optimizing the environment by providing familiar objects, clocks, calendars, and natural light. Avoiding any type of stress or emotional distress.

As delirium affects multiple parts in the brain, especially those which are involved in attention, memory, and executive functions. Some of the brain regions that are affected by delirium are the prefrontal cortex, the thalamus, and the basal ganglia. It can also cause changes in various neurotransmitters, such as acetylcholine, dopamine, glutamate, and serotonin. It can be caused by factors that originate outside or inside the brain. It causes long-term cognitive impairment, such as memory loss, dementia, or reduced thinking skills. Delirium may also increase the risk of mortality, institutionalization, and health care costs. The longer the duration of delirium, the worse the long-term outcomes may be. It may also worsen the prognosis of patients with pre-existing cognitive impairment.

The best medication for delirium depends on the cause and severity of the condition. As the medication should be based upon the careful assessment of patient's medical history, symptoms, and response to treatment. The dose and duration of medication should be adjusted according to the patient's condition and monitored closely for adverse effects. The first goal of delirium treatment is to address any causes or triggers, such as infection, dehydration, pain, or medication withdrawal. Treatment also focuses on creating the best setting for healing the body and calming the brain, such as providing adequate fluids and nutrition, assisting with movement, avoiding stressful conditions, and ensuring good sleep habits.