Factors affecting hallucinations in patients with delirium

Area of Science:

• Neuroscience
• Psychiatry

Background:

• Delirium is a complex condition with multifactorial causes and various subtypes.
• Understanding specific delirium subtypes, particularly those involving hallucinations, is crucial for effective treatment and care.

Purpose of the Study:

• To investigate factors associated with delirium, focusing on cases with prominent hallucinations.
• To identify potential reversible causes contributing to hallucinatory delirium.

Main Methods:

• A cohort of 602 delirium patients was analyzed retrospectively (May 2015 - August 2020).
• The Delirium Rating Scale-revised-98 assessed perceptual disturbances and hallucinations.
• Multiple regression analysis identified factors associated with hallucinations.

Main Results:

• Hallucinations were present in 25.9% of delirium patients, with visual hallucinations being most common.
• Significant associations were found between hallucinations and alcohol consumption, benzodiazepine withdrawal, angiotensin II receptor blocker use, and dopamine receptor agonist use.
• These identified factors are potentially reversible, stemming from exogenous substance use or withdrawal.

Conclusions:

• Alcohol consumption, benzodiazepine withdrawal, and the use of specific medications (ARBs, dopamine agonists) are significantly associated with delirium-induced hallucinations.
• These findings highlight the importance of considering substance use and withdrawal in managing patients with hallucinatory delirium.
• Targeting these reversible factors may offer new avenues for delirium management and prevention.