Delirium after cardiac surgery : a prospective study

Delirium was one of the first mental disorders described by the ancient medical writers some 2500 years ago [1]. In his extensive and excellent monograph "Delirium: Acute Confusional States", Lipowski describes the historical development of the concept of this disorder in detail, from the time of Hippocrates till the twentieth century [IJ. His most important and remarkable finding in tracing the history of delirium is the accuracy and consistency of the clinical description, despite the confusing variety of terms applied over the centuries to the same set of symptoms. Hereafter, the most important facts from his historical outline on delirium will be summarized [1]. At first, in antiquity, what nowadays is called delirium was referred to as 'phrenitis'. It was regarded as an acute mental disorder usually associated with fever and characterized by cognitive and behavioural disturbances as well as disruption of sleep. Phrenitis was described as marked by restless and excited behaviour, while 'lethargus', considered as the opposite of phrenitis, featured listlessness, sleepiness, inertia, memory loss and dulling of the senses. Lethargus could change into phrenitis and vice versa. Only in the late eighteenth century the word delirium gradually came to replace both of the earlier terms. Celsus was the first medical 'Writer known to use the term 'delirium'. He, as the other ancient medical 'Writers, recognized delirium or phrenitis as one of the most important mental disorders at that time.

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