To determine which psychological processes during delirium might
correlate with and predict postdelirium psychological outcome, the authors
prospectively studied 34 burn patients who became delirious during
hospitalization. After the delirium resolved, seven of the 25 survivors had
severe psychological symptoms--either depression or posttraumatic stress
disorders. During delirium, this outcome group was clinically distinctive:
They showed significantly more preoccupation with their trauma and injury,
had greater anxiety and fear, and differed in their use of defensive
operations. These findings suggest modifying the standard approach to the
delirious patient.
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