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Delirium among children and adolescents in an urban sub-Saharan African setting

Sean Hatherill1, Alan J Flisher, Rene Nassen

  • 1University of Cape Town and Red Cross War Memorial Children's Hospital, South Africa. Sean_Hatherill@health.qld.gov.au

Journal of Psychosomatic Research
|July 14, 2010
PubMed

Insights

Children with delirium referred to psychiatry face high mortality risks and complex causes. While antipsychotics like haloperidol and risperidone show moderate effectiveness, more research is needed for treatment guidelines.

Area of Science:

  • Pediatric Psychiatry
  • Child and Adolescent Psychiatry
  • Neuroscience

Background:

  • Delirium is an underresearched condition in pediatric populations.
  • Hospitalized children and adolescents with delirium present unique clinical challenges.

Purpose of the Study:

  • To characterize the demographic and clinical profile of pediatric delirium cases referred to psychiatry.
  • To assess mortality rates and treatment effectiveness in this patient group.

Main Methods:

  • Prospective case series of 23 children and adolescents diagnosed with delirium.
  • Referral to a consultation-liaison psychiatry service in a South African children's hospital.
  • Diagnosis based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria.

Main Results:

  • Patients represent a high-risk subgroup with significant mortality.
  • Complex, multifactorial, and often uncertain etiologies were observed.
  • Haloperidol and risperidone demonstrated moderate effectiveness in uncontrolled data when used with specific criteria.

Conclusions:

  • Delirium in children and adolescents is a critical, understudied area.
  • Tentative criteria for antipsychotic use are proposed.
  • Urgent need for controlled studies comparing pharmacological and non-pharmacological treatments.
Abstract

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