Delirium Explained: Clinical Features-Diagnosis & Recognition Essentials

Episode 3.3 – Delirium Explained: Clinical Features-Diagnosis & Recognition Essentials
with Dr. Mark Oldham, Associate Professor of Psychiatry at University of Rochester Medical Center, President-Elect of the American Delirium Society, and Deputy Editor of the Journal of the Academy of Consultation-Liaison Psychiatry

In this high-yield episode of Psychiatry Boot Camp, we are joined once again by Dr. Mark Oldham for a focused discussion on the clinical presentation and diagnosis of delirium. Dr. Oldham brings deep expertise and clarity to one of the most commonly misdiagnosed—and underrecognized—conditions in both medical and psychiatric practice.

Whether you're on your consultation-liaison psychiatry rotation, working in acute care, or simply want to refine your diagnostic skills, this episode provides the foundational knowledge you need to accurately identify delirium and differentiate it from other causes of altered mental status.

🔍 What You'll Learn:
🔹 What Is Delirium?
Understand delirium as a neuropsychiatric syndrome marked by acute cognitive dysfunction and fluctuating awareness, often in medically ill patients.

🔹 Clinical Features & Presentation
Learn how delirium manifests—including attention deficits, altered arousal, disorganized thinking, hallucinations, and psychomotor disturbances.

🔹 Epidemiology and Risk Factors
Discover the populations most vulnerable to delirium (elderly, ICU patients, those with baseline dementia), and why early recognition is critical.

🔹 Delirium vs. Dementia vs. Psychosis
Dr. Oldham helps you clearly distinguish delirium from overlapping disorders with overlapping symptoms—but differing implications.

🔹 Diagnosis in Practice
Explore evidence-based diagnostic tools like the Confusion Assessment Method (CAM) and the role of collateral history in identifying acute changes.

🔹 Why Delirium Matters
Understand the serious implications of delirium—including increased morbidity, mortality, and long-term cognitive decline—and why psychiatrists and non-psychiatrists alike must stay vigilant.

⏱️ Timestamps:
00:00 – Introduction to Dr. Mark Oldham
02:15 – What is delirium and why is it often missed?
06:45 – Core diagnostic features and subtypes (hyperactive, hypoactive, mixed)
11:10 – Delirium vs. dementia vs. psychosis
15:40 – Clinical tools for assessment (e.g., CAM, 4AT)
21:00 – Challenges in diagnosis in hospitalized patients
26:30 – Summary & key takeaways

📚 Related Resources:
🔗 Episode Website with References:
2.4 – Delirium (Expanded Episode)

🔗 Confusion Assessment Method (CAM) Tool
Learn More (Harvard/CAM)

🔗 American Delirium Society
https://americandeliriumsociety.org

👨‍⚕️ Who Is This For?
Psychiatry and internal medicine residents

Hospitalists and ICU clinicians

Emergency department providers

Geriatric care professionals

Medical students rotating on C-L psychiatry

Psychiatrists looking to sharpen inpatient diagnostic skills

🧠 Why This Episode Matters:
Delirium is underdiagnosed in more than 60% of cases, yet it carries devastating outcomes when missed. This episode arms clinicians with the awareness, language, and clinical tools to detect it early, communicate effectively with teams, and initiate timely interventions that may save lives.

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