The Confusion Assessment Method (CAM) is a widely used diagnostic tool for identifying delirium. It was developed by researchers at the Yale University School of Medicine and has become the gold standard for diagnosing delirium in clinical settings. The CAM helps healthcare professionals systematically evaluate and identify the presence of delirium based on four key features.
Delirium
Diagnostic Criteria for Delirium
Delirium is also known as acute confusional state, altered mental status, and toxic metabolic encephalopathy, among more than 30 descriptive terms. Delirium can be thought of as acute brain failure and is the final common pathway of multiple mechanisms, similar to acute heart failure. The official definition of delirium in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), requires a disturbance in attention and awareness that develops acutely and tends to fluctuate. The pathophysiological mechanisms of delirium remain poorly understood; leading models include neurotransmitter imbalance and neuroinflammation.
DSM-5 Criteria for Withdrawal Delirium (Delirium Tremens)
The criteria for withdrawal delirium, are delirium (a rapid-onset fluctuating disturbance of attention and cognition, sometimes with hallucinations) plus alcohol withdrawal.
Scoring Systems for the Diagnosis of Delirium in Critically Ill Patients
Two scales are in common use, the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC).