How is delirium differentiated from depression?

Updated: Apr 25, 2019
  • Author: Kannayiram Alagiakrishnan, MD, MBBS, MPH, MHA; Chief Editor: Glen L Xiong, MD  more...
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Answer

Delirium is mistaken for dementia or depression, especially when patients are quiet or withdrawn. However, by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM5) criteria, dementia cannot be diagnosed with certainty when delirium is present. Health professionals can do Mini-Mental Status Exam (MMSE), [20] depression assessment screening using DSM-5 criteria, [1] or the Geriatric Depression Scale (GDS). [21] They can also assess for suicidal and homicidal risk if necessary. Health professionals can directly ask patients about suicidal or homicidal ideation (thoughts), intent, and plan.

Depression symptoms are commonly seen with delirium. In a recent study, patients having symptoms of dysphoric mood and hopelessness are at risk for incident delirium while in the hospital. [22] On the other hand, hypoactive delirium may be mistaken for depression. Up to 42% of patients referred to psychiatry services for suspected depressive illness in the hospital may have delirium. [23] Screening for depression in the presence of delirium is quite challenging.


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