The Controversial Diagnosis of “Excited Delirium”

9780849316111Journalist Justin Jouvenal has written an article for The Washington Post examining the debate swirling around a syndrome dubbed “excited delirium.” Proponents have applied the term to what is believed to be a syndrome affecting certain individuals “Influenced by mental illness or the use of such stimulants as cocaine and methamphetamine” who, when in “its grip often have extraordinary strength, are imperviousness (sic) to pain and act wildly or violently. Then, suddenly, some die.” Critics, however, have noted the popularity of the diagnosis in cases involving suspected excessive force by police in the United States, concerned that it is providing cover for abusive policing practices.

According to Jouvenal’s sources, the concept dates back to the mid-19th century, but started to gain currency more recently in the mid-1980s. Medical examiners in Miami at the time began applying the term in the midst of the cocaine epidemic spreading across Florida.

    • Edward (Ned) Shorter
    • May 8th, 2015

    There is no doubt that “excited delirium” is a real psychiatric condition, although some patients who subsequently (postmortem) are given this diagnosis may be victims of police brutality. “Manic delirium” was in the past often a synonym. The syndrome is a form of catatonia; it is heralded by hyperpyrexia, and responds well to standard anticatatonic remedies. The tragedy is that many patients with this condition die in custody before the opportunity to treat them arises. I describe the syndrome in considerable detail in my new book What Psychiatry Left Out (Routledge).

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      • gae16802
      • May 11th, 2015

      Thank you for the suggestion. We generally try to keep our posts brief, however, opting to direct readers to lengthier pieces, where they can follow up on the topic in greater detail.

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