Can delirium relieve psychosis?

Chitra Malur, Max Fink, Andrew Francis, Chitra Malur, Max Fink, Andrew Francis

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

A delirium presages a poor prognosis in hospitalized patients, but an incidental delirium is a feature of some psychiatric treatments. We report five cases in which delirium preceded the relief of affective and psychotic symptoms of a major mental illness. The experience stimulated a review of the literature on delirium in psychiatric treatments. Five inpatients (aged 53 to 69 years) with an exacerbation of chronic mental iUness developed deliria from medications (n = 4) and electrolyte disturbance (n = 1). The deliria were managed with medication washout or correction of electrolyte imbalance. The progress of the patients was noted clinically and summarized. The clinical signs of delirium such as confusion, disorganized speech, sleep-wake cycle changes, and hallucinations persisted for 24 to 72 hours. As the delirium cleared, psychotic and affective symptoms improved or resolved. The improvements persisted for I to 5 months, with low doses of medications in two of the cases. A delirium may precede clinical improvement in affective and psychotic symptoms. Historically, some treatments for mental illness induce an incidental delirium (e.g., electroconvulsive therapy [ECT] and insulin coma). Why a delirium should presage a beneficial effect on psychosis is unclear, but the emergence of delirium may herald a beneficial pathophysiology. Copyright (C) 2000 by W.B. Saunders Company.

Original languageEnglish (US)
Pages (from-to)450-453
Number of pages4
JournalComprehensive Psychiatry
Volume41
Issue number6
DOIs
StatePublished - Jan 1 2000

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Can delirium relieve psychosis?'. Together they form a unique fingerprint.

  • Cite this

    Malur, C., Fink, M., Francis, A., Malur, C., Fink, M., & Francis, A. (2000). Can delirium relieve psychosis? Comprehensive Psychiatry, 41(6), 450-453. https://doi.org/10.1053/comp.2000.16565