Delirium is described as having which two presentations?

• A. Hyperactive and hypoactive presentations
• B. Mild and severe
• C. Acute and chronic
• D. Early and late

Answer: (A)

Delirium commonly presents in two motor patterns: hyperactive and hypoactive. The hyperactive form involves increased motor activity and agitation—restlessness, pacing, distractibility, and sometimes aggressive or combative behavior, often with perceptual disturbances like hallucinations. The hypoactive form shows reduced activity and responsiveness—lethargy, slowed speech and thinking, diminished attention, and withdrawal. Both patterns reflect an acute, fluctuating disturbance of attention and awareness, and many patients can exhibit a mix of both at different times. Recognizing hypoactive delirium is especially important, as it is frequently overlooked and can be mistaken for depression or dementia, delaying treatment of the underlying cause.