RECOGNIZING AND MANAGING DISTORTED/DISABLED COGNITION IN DELIRIUM

Abstract

There is general understanding that cognition is temporally impaired when a child or adult is delirious. A growing amount of research is seeking to understand the long-term impact of pediatric delirium (PD) and the underlying causes on long-term cognition. We will present current thinking about the assessment of PD among diverse populations, and the associated cognitive differences, distortions, and disabilities, as well as current research on the associated cognitive outcomes. We will begin with a case presented by Ruth Russell, MD (Montreal, Canada), who will connect the audience to experiences with patients with missed delirium diagnoses, potentially contributing to negative impacts on management and outcomes. Next, a presentation weaving in current research data by Lara Nelson, MD (Los Angeles, CA), a pediatric intensivist, will describe intensivists’ understanding of cognition, its impact on diagnosis, management, and long-term outcomes of children with and without PD. Next, Chase Samsel, MD (Boston, MA), will describe cognitive research in young patients with congenital and complex cardiac disease. Then, Gabrielle Silver, MD (New York, NY), will describe adaptations of the Cornell Assessment of Pediatric Delirium for use in moderate and severely delayed children as well as translations to other languages and cultures. Finally, Catherine Fuchs, MD (Nashville, TN), will discuss how these varied approaches inform understanding PD and how this can inform our understanding of cognition and neuropsychiatric functioning in children and adolescents. The audience of clinicians and researchers will be drawn to think about cases in which they or others have initially missed the diagnosis of PD or in which long-term follow-up may have been warranted to monitor and manage cognitive sequelae. The audience will be introduced to various approaches to clinical and research-related science about cognition in the pediatric patient and after hospitalization. The remaining time will be dedicated to questions and answers. Cognition in the setting of acute neuropsychiatric illness and postrecovery is an underdescribed and underevaluated part of child and adolescent psychiatry. Pediatric delirium is an important entity for understanding some of these critical complexities related to how we may facilitate better outcomes in our child and adolescent psychiatry patients.