Using the DSM-5 criteria for<unk>  as framework, the early recognition of signs/symptoms and a careful history, along with any of multiple clinical instruments, can help in making a diagnosis of<unk> . A diagnosis of<unk>  cannot be made without a previous assessment of the patient's baseline level of cognitive function. In other words, a mentally-disabled or demented person might appear to be delirious, but may actually just be operating at his/her baseline mental ability. General setting Multiple guidelines recommend that<unk>  should be diagnosed when it presents to healthcare services. Much evidence reveal, however, that<unk>  is greatly under-diagnosed. Higher rates of detection of<unk>  in general settings can be assisted by the use of validated<unk>  screening tools. Many such tools have been published. They differ in duration, complexity, need for training, etc. Examples of tools in use in clinical practice are: * Richmond Agitation and Sedation Scale (RASS) – highly sensitive and specific for diagnosing<unk>  in older patients * Observational Scale of Level of Arousal (OSLA) – highly sensitive and specific for diagnosing<unk>  in older patients * Confusion Assessment Method (CAM) *<unk>  Observation Screening Scale (DOS) * Nursing<unk>  Screening Scale (Nu-DESC) * Recognizing Acute<unk>  As part of your Routine (RADAR) * 4AT (4 A's Test) *<unk>  Diagnostic Tool-Provisional (DDT-Pro), also for subsyndromal<unk>  Intensive care unit People who are in the ICU are at greater risk of<unk>  and ICU<unk>  may lead to prolonged ventilation, longer stays in the hospital, increased stress on family and caregivers, and an increased chance of death. In the ICU, international guidelines recommend that every patient gets checked for<unk>  every day (usually twice or more a day) using a validated clinical tool. The definition of<unk>  that healthcare professionals use at the bedside is whether or not a patient can pay attention and follow simple commands. The two most widely used are the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care<unk>  Screening Checklist (ICDSC). Translations of these tools exist in over 20 languages and are used ICUs globally with instructional videos and implementation tips available. More emphasis is placed on regular screening over the choice of tool used. This, coupled with proper documentation and informed awareness by the healthcare team, can affect clinical outcomes. Without using one of these tools, 75% of ICU<unk>  can be missed by the healthcare team, leaving the patient without any likely interventions to help reduce the duration of<unk> . Differential diagnosis There are conditions that might have similar clinical presentations to those seen in<unk> . These include dementia, depression, psychosis, and other conditions that affect cognitive function. *Dementia: This group of disorders is acquired (non-congenital) with usually irreversible cognitive and psychosocial functional decline. Dementia usually results from an identifiable degenerative brain disease (e.g. Alzheimer disease or Huntington's disease), requires chronic impairment (versus acute onset in<unk> , and is typically not associated with changes in level of consciousness. *Depression: Similar symptoms exist between depression and<unk>  (especially the hypoactive subtype). Gathering a history from other caregivers can clarify baseline mentation. *Other mental illnesses: Some mental illnesses, such as a manic episode of bipolar disorder, depersonalization disorder, or some types of acute psychosis may cause a rapidly fluctuating impairment of cognitive function and ability to focus. These, however, are not technically causes of<unk>  per DSM-5 criteria D (i.e. fluctuating cognitive symptoms occurring as part of a primary mental disorder are results of the said mental disorder itself), while physical disorders (e.g. infections, hypoxia, etc.) can precipitate<unk>  as a mental side-effect/symptom. *Psychosis: Consciousness and cognition may not be impaired (however, there may be overlap, as some acute psychosis, especially with mania, is capable of producing<unk> -like states).
Delirium
Dementia
Excited delirium
Status epilepticus
Ateliosis
Dancing mania
Oneiroid syndrome
Depression of Alzheimer disease