Delirium is a pronounced disorder of object orientation with the preservation of personal orientation. Productive pathopsychological symptoms are expressed in the form of hallucinations, fear affect, sensory delirium and often psychomotor agitation.
The behavior reflects the content of hallucinations and sensory delusions. Delirium is characterized by the presence of stages in the development process.
- The stage of harbingers (the initial stage). There is a talkativeness, general excitement. Distraction, inconsistency, emotional lability are expressed. The phenomena of general hyperesthesia are characteristic: bright light is unpleasant, the usual food gets an intense taste, unpleasant odors become unbearable, patients shudder even at minor sounds.
- The hypnagogic stage. It is characterized by an increase in the symptoms of the first stage. In the statements of the patient, inconsistency is noticeable, reaching the level of slight incoherence. Occasionally, there are phenomena of allopsychic disorientation. With closed eyes – hypnagogic hallucinations. Visual illusions appear.
- The stage of hallucinations. The appearance of bright true visual, auditory and tactile hallucinations is characteristic. The patient’s behavior is dictated by the content of hallucinatory experiences. Facial expressions express affective experiences. A figurative, sensual delirium appears. Autopsychic orientation is preserved, patients are completely disoriented in the surrounding environment.
The manifestation of psychopathological symptoms weakens somewhat during the day, lucid windows are noted – short periods of clear consciousness. By the evening, the psychopathological symptoms increase, persistent insomnia is noted.
If the development of delirium is limited to the second or third stage, then patients retain partial memories of existing mental disorders.
With the unfavorable development of the underlying disease, which was the cause of mental disorders, severe forms of delirium can be noted – professional and mussitating.
Professional delirium (delirium of employment). It is characterized by the performance of monotonous habitual or professional actions (cooking, sewing, cleaning, etc.). Motor excitement usually occurs in a limited space, accompanied by individual rare words or short phrases. Speech contact is almost impossible. Amnesia is always complete.
Mussitating (“muttering”,” quiet ” delirium). Uncoordinated motor excitement within the bed is characteristic. Patients shake off something from themselves, make grasping movements. Speech is a quiet inarticulate mumble. Speech contact is not possible.
The duration of delirium is up to a week. The disappearance of disorders usually occurs critically, followed by deep sleep.