Do you understand what insanity is?

Spirit plays a very important role in people's daily lives. It can dominate people's daily lives and play a guiding role in daily life. If the mind becomes disordered, it will affect our life and work in all aspects, bring great disadvantages, and also cause various physical illnesses. Mental disorders are more common in the elderly, but it is not ruled out that young and middle-aged people may suffer from mental disorders due to increased stress. The causes of mental disorders include structural causes and infectious causes. Patients need to choose appropriate treatment methods according to their different situations in order to recover better.

1. Causes

Metabolic or toxic causes

Virtually any metabolic disease may cause delirium. Some important metabolic and toxic causes of delirium are listed in Table 171-2. Among the elderly, adverse drug reactions are the most common cause.

1. Structural causes

Structural lesions that may precipitate delirium include cerebrovascular occlusion and infarction, subarachnoid hemorrhage, primary or metastatic brain tumors, subdural hematoma, and brain abscess. Most structural lesions can be detected by CT or MRI, and many lesions produce focal neurologic signs that can be observed during physical examination.

2. Infectious causes

Infectious causes of delirium include acute meningitis or encephalitis or various infections outside the brain, which may cause delirium through toxin production or fever. Pneumonia (even without oxygen deficiency), urinary tract infection, sepsis, or fever caused by viral infection can all cause mental confusion in a vulnerable brain. Slow-developing abscesses or opportunistic infections are more difficult to diagnose clinically, and in some cases a brain biopsy may be required for correct diagnosis.

2. Symptoms and Signs

Symptoms of delirium often fluctuate rapidly, even within minutes, and tend to worsen after sunset (sundowning). The most obvious symptom is clouding of consciousness accompanied by disorientation to time, place, and people. It is difficult to concentrate. There is often confusion about common daily events and daily routines. Personality and mood changes are common. Symptoms include irritability, inappropriate behavior, fearfulness, excessive energy, or even overt signs of psychosis, such as delusions, hallucinations (usually visual), or paranoia. Some patients appear quiet, withdrawn, or apathetic, whereas others are agitated or hyperactive; physical restlessness often manifests as restless pacing. For brief periods the patient may display conflicting emotions. Thoughts are not organized, speech is incoherent, often with marked slurring of speech, rapid speech, coined words, aphasic errors, or disorganized speech patterns. Normal sleeping and eating patterns are often significantly disrupted. Some patients may experience dizziness.