Delirium in children and adolescents: A systematic review of the literature

Objectives: The purpose of this study was to collate all works relating to delirium and probable delirium in children and adolescents published since 1980. Methods: A systematic review of the literature in all languages published between 1980 and March 2009 was conducted. Results: The literature is limited to small case series and case reports including a total of 217 children or adolescents with definite delirium and a further 136 children and adolescents with "probable delirium." These articles, in addition to unsystematic reviews, overviews, editorials, journal commentaries, and pertinent book chapters, are discussed in relation to prevalence, predisposing and precipitating factors, phenomenology, residual psychopathology, mortality, management, and prevention of delirium in childhood and adolescence. Conclusions: Delirium is an important but neglected disorder of childhood associated with significant morbidity and high mortality. Current clinical practice for management is based on slim empirical evidence. (C) 2010 Elsevier Inc. All rights reserved.