Acute confusional state see Delirium section in Chapter

Disturbance of consciousness or level of arousal characterized by reduced ability to focus, maintain, or shift attention, and accompanied by disturbances of cognition, mood, affect, and/or behavior. The disturbances typically develop over hours to days and tend to fluctuate during the course of the day. They include hypo- and hyperaroused states and encompass the spectrum from delirium to coma." Diagnostic criteria:

Disturbance of consciousness or level of arousal with reduced ability to focus, maintain, or shift attention, and one or more of the following developing over a short period of time (hours to days) and tending to fluctuate during the course of the day:

a. Acute or subacute change in cognition that may include memory deficit and disorientation.

b. A change in behavior, mood, or affect (e.g., restlessness, overactivity, reversal of the sleep/wakefulness cycle, irritability, apathy, anxiety, mood lability, etc.).

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