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Table 2 DSM-5 and ICD-10 diagnosis of delirium

From: An interdisciplinary statement of scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT)

 

DSM-5

ICD-10

Attention

Disturbance in ability to direct, focus, sustain, or shift attention.

Reduced ability to focus, sustain, or shift attention.

Awareness

Disturbance in awareness environmental orientation.

Clouding of consciousness, that is, reduced clarity of awareness of the environment.

Timing / Fluctuation

Develops quickly (hours to days) and represents a change from baseline and fluctuates over a day.

Rapid onset and fluctuations of the symptoms over the course of the day.

Memory Deficit

An additional disturbance in cognition (e.g. memory deficit, disorientation, language, visuospatial ability, or perception).

Disturbance of cognition, manifest by both: (1) impairment of immediate recall and recent memory, with relatively intact remote memory; (2) disorientation in time, place, or person.

Psychomotor Deficit

None

At least one of the following psychomotor disturbances: (1) rapid unpredictable shifts from hypoactivity to hyperactivity; (2) increased reaction time; (3) increased or decreased flow of speech; (4) enhanced startle reaction.

Sleep Disturbance

None

Disturbance of sleep or the sleep/wake cycle, manifest by at least one of the following: (1) insomnia, which in severe cases may involve total sleep loss, with or without daytime drowsiness, or reversal of the sleep/wake cycle; (2) nocturnal worsening of symptoms; (3) disturbing dreams and nightmares that may continue as hallucinations or illusions after awakening.

Corroborating Data

There is evidence from the history, physical examination or laboratory findings that the disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal, or exposure to a toxin, or is due to multiple etiologies.

Objective evidence from history, physical and neurological examination, or laboratory tests of an underlying cerebral or systemic disease (other than psychoactive substance-related) that can be presumed to be responsible for the clinical manifestations.

Other Cognitive Disorders

Not better explained by a pre-existing, established or evolving neurocognitive disorder and do not occur in the context of a severely reduced level of arousal, such as coma.

None