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2011 | OriginalPaper | Hoofdstuk

65 Verwardheid

Auteurs : K. van der Meer, T.W.D.P. van Os

Gepubliceerd in: Diagnostiek van alledaagse klachten

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Verwardheid is een indrukwekkend symptoom waarachter een groot aantal aandoeningen kan schuilgaan: bij jongeren vooral schizofrenie, middelengebruik en alcoholonthouding. Zeker bij ouderen moet men uitgaan van een multifactoriële conditie waarbij onderscheid kan worden gemaakt tussen verschillende predisponerende factoren (hoge leeftijd, dementie, polyfarmacie, psychiatrische stoornissen) en luxerende factoren (infecties, alcohol, farmaca, metabole en endocriene ziekten, trauma, cerebrale aandoeningen, cardiovasculaire aandoeningen).
Vooral bij ouderen heeft het delier een minder gunstig beloop, met een verhoogde kans op blijvende hulpbehoevendheid of overlijden.
Literatuur
1.
go back to reference Westing IFM van, Vries H de, Feyen W, et al. Acute psychiatrie in de huisartspraktijk: Angst en onrust. Modern Medicine 2000;3:110-6. Westing IFM van, Vries H de, Feyen W, et al. Acute psychiatrie in de huisartspraktijk: Angst en onrust. Modern Medicine 2000;3:110-6.
2.
go back to reference Lipowski ZJ. Delirium in the eldery patient. N Engl J Med 1989;20:578-82. Lipowski ZJ. Delirium in the eldery patient. N Engl J Med 1989;20:578-82.
3.
go back to reference Inouye SK. Delirium in hospitalized older patients. J Geriatr Psychiatry Neurol 1998;11:118-25. Inouye SK. Delirium in hospitalized older patients. J Geriatr Psychiatry Neurol 1998;11:118-25.
4.
go back to reference Folstein MF, Bassett SS, Romanoski AJ, et al. The epidemiology of delirium in the community: the Eastern Baltimore Mental Health Survey. Int Psychogeriatr 1991;3:169-76. Folstein MF, Bassett SS, Romanoski AJ, et al. The epidemiology of delirium in the community: the Eastern Baltimore Mental Health Survey. Int Psychogeriatr 1991;3:169-76.
5.
go back to reference Martin NJ, Stones J, Young JE, et al. Development of delirium: a prospective cohort study in a community hospital. Int Psychogeriatr 2000;12:117-27. Martin NJ, Stones J, Young JE, et al. Development of delirium: a prospective cohort study in a community hospital. Int Psychogeriatr 2000;12:117-27.
6.
go back to reference Hemert AM van, Mast RC van der, Hengeveld MW, et al. Excess mortality in general hospital patients with delirium: a 5-year follow-up of 519 patients seen in psychiatric consultation. J Psychosom Res 1994;38:339-46. Hemert AM van, Mast RC van der, Hengeveld MW, et al. Excess mortality in general hospital patients with delirium: a 5-year follow-up of 519 patients seen in psychiatric consultation. J Psychosom Res 1994;38:339-46.
7.
go back to reference Albronda T, Bruijns E, Willekens FLA. Diagnosen en ontslagbestemmingen van patiënten opgenomen wegens psychisch disfunctioneren op een afdeling geriatrie. Ned Tijdschr Geneeskd 1996;140:1993-6. Albronda T, Bruijns E, Willekens FLA. Diagnosen en ontslagbestemmingen van patiënten opgenomen wegens psychisch disfunctioneren op een afdeling geriatrie. Ned Tijdschr Geneeskd 1996;140:1993-6.
8.
go back to reference Olde Rikkert MGM, Lisdonk EH van de. ABC voor analyse van acute verwardheid bij ouderen. Huisarts Wet 2001;44:291-6. Olde Rikkert MGM, Lisdonk EH van de. ABC voor analyse van acute verwardheid bij ouderen. Huisarts Wet 2001;44:291-6.
9.
go back to reference Weele GM van der, Dijk A van, Eekhof JAH, Olde Rikkert MGM, Scholtes ABJ, Veehof LJG, et al. NHG-Standaard Delier bij ouderen. Huisarts Wet 2003;46(3):141-6. Weele GM van der, Dijk A van, Eekhof JAH, Olde Rikkert MGM, Scholtes ABJ, Veehof LJG, et al. NHG-Standaard Delier bij ouderen. Huisarts Wet 2003;46(3):141-6.
10.
go back to reference DSM-IV Patiëntenzorg. Diagnostiek en classificatie van psychische stoornissen voor de geneeskunde. Lisse: Swets en Zeitlinger, 1996. DSM-IV Patiëntenzorg. Diagnostiek en classificatie van psychische stoornissen voor de geneeskunde. Lisse: Swets en Zeitlinger, 1996.
11.
go back to reference Werf GTh van der, Smith RJA, Stewart RE, et al. Spiegel op de huisarts. Groningen: Rijksuniversiteit Groningen, Disciplinegroep Huisartsgeneeskunde, 1998. Werf GTh van der, Smith RJA, Stewart RE, et al. Spiegel op de huisarts. Groningen: Rijksuniversiteit Groningen, Disciplinegroep Huisartsgeneeskunde, 1998.
12.
go back to reference Lisdonk EH van, Bosch WJHM van den, Huygen FJA, Lagro-Janssen ALM, Schers HJ. Ziekten in de huisartspraktijk. Maarssen: Elsevier Gezondheidszorg, 2008. Lisdonk EH van, Bosch WJHM van den, Huygen FJA, Lagro-Janssen ALM, Schers HJ. Ziekten in de huisartspraktijk. Maarssen: Elsevier Gezondheidszorg, 2008.
13.
go back to reference Afdeling Sociale Geneeskunde, afdeling Psychiatrie, afdeling Huisartsgeneeskunde. Regioproject Nijmegen 2: Psychiatrische morbiditeit in de regio. Nijmegen: Katholieke Universiteit Nijmegen, 1999. Afdeling Sociale Geneeskunde, afdeling Psychiatrie, afdeling Huisartsgeneeskunde. Regioproject Nijmegen 2: Psychiatrische morbiditeit in de regio. Nijmegen: Katholieke Universiteit Nijmegen, 1999.
14.
go back to reference Okkes IM, Oskam SK, Lamberts H. Van klacht naar diagnose. Bussum: Coutinho, 1998. Okkes IM, Oskam SK, Lamberts H. Van klacht naar diagnose. Bussum: Coutinho, 1998.
15.
go back to reference Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA 1990;263:1097-101. Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA 1990;263:1097-101.
16.
go back to reference Litaker D, Locala, FK, Bronson DL, et al. Preoperative risk postoperative delirium. Gen Hosp Psychiatry 2001;23:84-9. Litaker D, Locala, FK, Bronson DL, et al. Preoperative risk postoperative delirium. Gen Hosp Psychiatry 2001;23:84-9.
17.
go back to reference Elie M, Cole MG, Primeau FJ, et al. Delirium risk factors in elderly hospitalized patients. J Gen Intern Med 1998;13:204-12. Elie M, Cole MG, Primeau FJ, et al. Delirium risk factors in elderly hospitalized patients. J Gen Intern Med 1998;13:204-12.
18.
go back to reference Schor JD, Levkoff SE, Lipsitz LA, et al. Risk factors for delirium in hospitalized elderly. JAMA 1992;26:827-31. Schor JD, Levkoff SE, Lipsitz LA, et al. Risk factors for delirium in hospitalized elderly. JAMA 1992;26:827-31.
19.
go back to reference Elie M, Rousseau F, Cole M, et al. Prevalence and detection of delirium in elderly emergency department patients. CMAJ 2000;163:977-81. Elie M, Rousseau F, Cole M, et al. Prevalence and detection of delirium in elderly emergency department patients. CMAJ 2000;163:977-81.
20.
go back to reference Levkoff SE, Evans DA, Liptzin B, et al. J. Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients. Arch Intern Med 1992;152:334-40. Levkoff SE, Evans DA, Liptzin B, et al. J. Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients. Arch Intern Med 1992;152:334-40.
21.
go back to reference Marcantonio ER, Flacker JM, Wright RJ, et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001;49:516-22. Marcantonio ER, Flacker JM, Wright RJ, et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001;49:516-22.
22.
go back to reference Williams-Russo P, Sharrock NE, Mattis S, et al. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA 1995;274:44-50. Williams-Russo P, Sharrock NE, Mattis S, et al. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA 1995;274:44-50.
23.
go back to reference Dai YT, Lou MF, Yip PK, et al. Risk factors and incidence of postoperative delirium in elderly Chinese patients. Gerontology 2000;46:28-35. Dai YT, Lou MF, Yip PK, et al. Risk factors and incidence of postoperative delirium in elderly Chinese patients. Gerontology 2000;46:28-35.
24.
go back to reference Pfitzenmeyer P, Musat A, Lenfant L, et al. Postoperative cognitive disorders in the elderly. Presse Med 2001;30:648-52. Pfitzenmeyer P, Musat A, Lenfant L, et al. Postoperative cognitive disorders in the elderly. Presse Med 2001;30:648-52.
25.
go back to reference Crul BJ, Hulstijn W, Burger IC. Influence of the type of anaesthesia on post-operative subjective physical well-being and mental function in elderly patients. Acta Anaesthesiol Scand 1992;36:615-20. Crul BJ, Hulstijn W, Burger IC. Influence of the type of anaesthesia on post-operative subjective physical well-being and mental function in elderly patients. Acta Anaesthesiol Scand 1992;36:615-20.
26.
go back to reference Williams-Russo P, Urquhart BL, Sharrock NE, et al. Post-operative delirium: predictors and prognosis in elderly orthopedic patients. J Am Geriatr Soc 1992;40:759-67. Williams-Russo P, Urquhart BL, Sharrock NE, et al. Post-operative delirium: predictors and prognosis in elderly orthopedic patients. J Am Geriatr Soc 1992;40:759-67.
27.
go back to reference Martin M, Figiel G, Mattingly G, et al. ECT-induced interictal delirium in patients with a history of a CVA. J Gertiatr Psychiatry Neurol 1992;5:149-55. Martin M, Figiel G, Mattingly G, et al. ECT-induced interictal delirium in patients with a history of a CVA. J Gertiatr Psychiatry Neurol 1992;5:149-55.
28.
go back to reference Verhagen EH, Eliel MR, Graeff A de, et al. Sedatie in de laatste levensfase. Ned Tijdschr Geneeskd 1999;143:2601-3. Verhagen EH, Eliel MR, Graeff A de, et al. Sedatie in de laatste levensfase. Ned Tijdschr Geneeskd 1999;143:2601-3.
29.
go back to reference Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med 2000;160:786-94. Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med 2000;160:786-94.
30.
go back to reference Weinrich S, Sarna L. Delirium in the older person with cancer. Cancer 1994;74(Suppl):2079-91. Weinrich S, Sarna L. Delirium in the older person with cancer. Cancer 1994;74(Suppl):2079-91.
31.
go back to reference Breibart W, Strout D. Delirium in the terminally ill. Clin Geriatr Med 2000;16:357-72. Breibart W, Strout D. Delirium in the terminally ill. Clin Geriatr Med 2000;16:357-72.
32.
go back to reference Rahkonen T, Luukkainen-Markkula R, Paanila S, et al. Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study. J Neurol Neurosurg Psychiatry 2000;69:519-21. Rahkonen T, Luukkainen-Markkula R, Paanila S, et al. Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study. J Neurol Neurosurg Psychiatry 2000;69:519-21.
33.
go back to reference Marcantonio ER, Juarez G, Goldman I. The relationship of postoperative delirium with psychoactive medications. JAMA 1994;272:1518-22. Marcantonio ER, Juarez G, Goldman I. The relationship of postoperative delirium with psychoactive medications. JAMA 1994;272:1518-22.
34.
go back to reference Tune LE, Bylsma FW. Benzodiazepine-induced and anticholinergic-induced delirium in the elderly. Int Psychogeriatr 1991;3:397-408. Tune LE, Bylsma FW. Benzodiazepine-induced and anticholinergic-induced delirium in the elderly. Int Psychogeriatr 1991;3:397-408.
35.
go back to reference Young BK, Camicioli R, Ganzini L. Neuropsychiatric adverse effects of antiparkinsonian drugs. Drugs Aging 1997;1:367-83. Young BK, Camicioli R, Ganzini L. Neuropsychiatric adverse effects of antiparkinsonian drugs. Drugs Aging 1997;1:367-83.
36.
go back to reference Gray SL, Lai KV, Larson EB. Drug-induced cognition disorders in the elderly: incidence, prevention and management. Drug Saf 1999;21:101-22. Gray SL, Lai KV, Larson EB. Drug-induced cognition disorders in the elderly: incidence, prevention and management. Drug Saf 1999;21:101-22.
37.
go back to reference Moore AR, O’Keeffe ST. Drug-induced cognitive impairment in the elderly. Drugs Aging 1999;15:15-28. Moore AR, O’Keeffe ST. Drug-induced cognitive impairment in the elderly. Drugs Aging 1999;15:15-28.
38.
go back to reference Waard JA van, Mast RC van der. Een delirium? Opname in het algemeen ziekenhuis, niet in het psychiatrische. Ned Tijdschr Geneeskd 2000;144:913-5. Waard JA van, Mast RC van der. Een delirium? Opname in het algemeen ziekenhuis, niet in het psychiatrische. Ned Tijdschr Geneeskd 2000;144:913-5.
39.
go back to reference Stroomer-van Wijk AJM, Kamperman KM. Ned Tijdschr Geneeskd 2000;144:1422-3. Stroomer-van Wijk AJM, Kamperman KM. Ned Tijdschr Geneeskd 2000;144:1422-3.
40.
go back to reference Mensink HJ, Heeren TJ. Delier in het verpleegtehuis. Ned Tijdschr Geneeskd 1995;139:257-9. Mensink HJ, Heeren TJ. Delier in het verpleegtehuis. Ned Tijdschr Geneeskd 1995;139:257-9.
41.
go back to reference Rahkonen T, Luukkainen-Markkula R, Paanila S, et al. R. Systematic intervention for supporting community care of elderly people after a delirium episode. J Neurol Neurosurg Psychiatry 2000;69:519-21. Rahkonen T, Luukkainen-Markkula R, Paanila S, et al. R. Systematic intervention for supporting community care of elderly people after a delirium episode. J Neurol Neurosurg Psychiatry 2000;69:519-21.
42.
go back to reference Zayas EM, Grossberg GT. The treatment of psychosis in late life. J Clin Psychiatry 1998;59 Suppl 1:5-10. Zayas EM, Grossberg GT. The treatment of psychosis in late life. J Clin Psychiatry 1998;59 Suppl 1:5-10.
43.
go back to reference Flacker JM, Marrcantonio ER. Delirium in the elderly. Optimal management. Drugs Aging 1998;13:119-30. Flacker JM, Marrcantonio ER. Delirium in the elderly. Optimal management. Drugs Aging 1998;13:119-30.
44.
go back to reference Carter GL, Dawson AH, Lopert R. Drug-induced delirium. Incidence, management and prevention. Drug Saf 1996 Oct;15(4):291-301. Carter GL, Dawson AH, Lopert R. Drug-induced delirium. Incidence, management and prevention. Drug Saf 1996 Oct;15(4):291-301.
45.
go back to reference Bross MH, Tatum NO. Delirium in the elderly patient. Am Fam Physician 1994;50:1325-32. Bross MH, Tatum NO. Delirium in the elderly patient. Am Fam Physician 1994;50:1325-32.
46.
go back to reference Francis J, Kapoor WN. Prognosis after hospital discharge of older medical patients with delirium. J Am Geriatr Soc 1992;40:601-6. Francis J, Kapoor WN. Prognosis after hospital discharge of older medical patients with delirium. J Am Geriatr Soc 1992;40:601-6.
Metagegevens
Titel
65 Verwardheid
Auteurs
K. van der Meer
T.W.D.P. van Os
Copyright
2011
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-313-8364-1_66