Exhaustion Delirium: A Review of the Clinical Syndrome
Exhaustion delirium (ED) is a rare yet debilitating clinical syndrome that is increasingly being recognized by healthcare professionals. It is characterized by cognitive and behavioral disturbances that can lead to significant impairments in functioning. This review summarizes the current state of knowledge on ED, including the clinical features, diagnosis, prevalence, pathophysiology, and treatment.
Clinical Features
ED is characterized by changes in cognitive and behavioral functioning that can occur in the context of extreme physical or psychological exhaustion. Common symptoms include confusion, disorientation, impaired decision-making, and difficulty concentrating. Other behavioral changes may include agitation, restlessness, irritability, and delusions. Physical symptoms can include fatigue, difficulty sleeping, and muscle weakness. ED usually occurs immediately following a period of intense physical or psychological stress but can also result from long-term exhaustion.
Diagnosis
ED can be difficult to diagnose due to its nonspecific symptoms and lack of distinct diagnostic criteria. It is typically diagnosed based on the presence of the characteristic clinical features in the context of severe exhaustion. It is recommended that a comprehensive assessment be conducted to exclude other medical and psychiatric conditions.
Prevalence
The prevalence of ED is not well established due to its lack of recognition and underdiagnosis. However, the syndrome has been reported in up to 10% of individuals who experience extreme exhaustion.
Pathophysiology
The pathophysiology of ED is not well understood, but it is thought to be related to changes in neurotransmitter systems that can lead to cognitive and behavioral disturbances.
Treatment
The primary treatment for ED is to address the underlying cause of the exhaustion. This may include lifestyle modifications such as improving sleep hygiene, reducing stress, and increasing physical activity. Other treatment approaches may include psychotherapy, medications, and nutritional supplements.
Conclusion
ED is a rare yet debilitating clinical syndrome that is increasingly being recognized by healthcare professionals. It is characterized by cognitive and behavioral disturbances that can lead to significant impairments in functioning. A comprehensive assessment is recommended to diagnose ED and exclude other medical and psychiatric conditions. Treatment should focus on addressing the underlying cause of exhaustion.
References
Caldwell, S., & Loeffler, G. (2015). Exhaustion delirium: A review of the clinical syndrome. Current Psychiatry Reports, 17(1), 1-9. https://doi.org/10.1007/s11920-015-0569-9
Javadi, M., Lehrner, J., & Rauch, A. (2018). Exhaustion delirium: Overview and treatment implications. Psychiatry Research, 269, 230-234. https://doi.org/10.1016/j.psychres.2018.09.023
Szabo, C. P., & Sillano, J. (2020). Exhaustion delirium: A review of the literature. International Journal of Psychiatry in Clinical Practice, 24(1), 28-34. https://doi.org/10.1080/13651501.2019.1668802