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Question:
How many doctors actually perform a battery of blood tests, thyroid, urine, drugs, MRI, etc. when a patient presents with a state of delirum which could cover the rainbow of just about every psychiatric category?
Answer:
I wonder if medicine is practiced like this in any country. To my knowledge, in my country, the external behaviour is immediately taken for granted upon the person's report ....."he looks depressed" kind of thing, and is referred to a psychologist for meds and "talk therapy". A biological check up might take much less time than years of psychotherapy, and may even be reversible. Even 19th century doctors like Pinel and Kraepelin knew that underlying biological diseases such as syphillis, uremia, alcoholism, thyroid disease, artherosclerosis, organic brain diseases, even high fever,and so many others, besides the constitutional hereditary components, were possible causes. Delirium is an acute illness with severely altered mental status. It's one of those medical emergencies. Most doctors will have that person evaluated in the ER immediately where a battery of test will be ordered including head CT and spinal tap. These patients will be admitted and seen by the neurologist. There are so many metabolic and infectious disorders that can present with delirium. Sometimes seizures present like this. I think the response to delirium may be slow if the patient is elderly and resides in a nursing home. I am glad to hear from someone who is an MD (really, are you?) that it is recognized as such if it is sudden, and efforts are made to diagnose it. The diagnosis may be easier if no psychiatric meds or perhaps others too, are taken, but after being on them, especially for elderly people who may react adversely to wrong dose, doubled, etc., it may be harder.
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