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In the general medical setting, as many as 30% of patients have a psychiatric disorder. Delirium is detected in 10% of all medical inpatients, and is detected in over 30% in some high-risk groups. Two-thirds of patients who are high users of medical care have a psychiatric disturbance: Around 23% have depression, 22% anxiety, and 20% somatization. Only a small subset of the population at risk is currently being adequately identified. Education of non-psychiatric physicians and allied health professionals about medical and psychiatric issues related to a patient's illness is a core component of the liaison model. Possibly because of the psychiatric nature of its manifestations, delirium is poorly recognized by non-psychiatric house staff. The aim of this study is to evidence incidence rates of under-diagnosis and provide an overview including prevention, diagnosis, and early management of delirium in general hospitals. A retrospective study was conducted at the Centenario Provincial Hospital of Rosario, Argentina, a tertiary care academic hospital. It was carried out during the period January 2010–June 2011, following the referrals of the house staff for 345 adult inpatients. The incidence of delirium, as well as the staff's diagnostic ability was analyzed. Of the total sample, the 19% developed an acute confusional state (ACS). Diagnosis had been correct in 51% of the cases, whereas misdiagnosis reached 49%. The under-diagnosis of ACS due to semiological misrecognition has been modified after an educational effort in the acquisition of screening skills carried out by the psychiatric and non-psychiatric staff together.

DOI: 10.1007/978-3-319-53126-7_32

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