Table 2:

Differentiating features of delirium from “pseudodelirium”

	DELIRIUM	DISORGANIZED PSYCHOSIS	GANSER SYNDROME	DELIRIOUS MANIA	PRIMARY CATATONIA
EEG	Diffuse slowing	No specific pattern	Typically normal	Unknown	Typically normal
Clinical status	Sick, often frail	Medically stable	Medically stable	Variable; often with autonomic activation	Medically stable
Arousal	Rarely appropriately alert	Alert	Fluctuates; may be alert for extended periods	Can alternate between hyperkinetic and stuporous	Usually stuporous, occasionally hyperkinetic
Interpersonal	Inattentive	Variable; often difficult to rule out inattention	Often engaged	Fluctuates; often inattentive	Disengaged, negativistic; occasionally automatically obedient
Verbal responses	Muddled thinking	Speech disorganized	Approximate answers common	Initially hyperverbal, may devolve to mutism	Mute, whispered, verbigeration, or echolalia
Sensorium	Clouded	Usually clear	Verbal content suggests clouding	Clouded in mid-to-late stages	Often clear but difficult to assess
Emotional state	Consistent with motor subtype	Often paranoid	Effortful engagement	Manic, may devolve to blunted state	Fearful, occasionally manic
Psychosocial	Reduced engagement	Difficult to engage	Bizarre; psychosocial stressor present	May be initially intrusive, then disengaged	Variable, related to underlying condition