Abstract

To the Editor: In 1980 APA replaced the DSM-III diagnosis "delirium tremens" with "alcohol withdrawal delirium." In the following, I describe a study that stemmed from the concern that not only can the term "alcohol withdrawal delirium" be easily confused with "alcohol withdrawal" but the diagnosis "alcohol withdrawal delirium" in general medicine is used indiscriminately, such that other potentially important underlying causes for delirium are often overlooked. Fifty patient charts from the University of New Mexico Hospital with a discharge diagnosis of "alcohol withdrawal delirium" were randomly selected by a medical records computer for 1994, 1996, and 1998 and were reviewed by me (director of the Psychiatric Consultation and Liaison Service), a trained research assistant, and a medical intern. Data were obtained regarding diagnosis, mental status observations, nursing notes, drinking history from the patient and his or her family, and presence of major medical and surgical problems. A retrospective diagnosis was made by consensus of the two senior clinicians. The patients were 47 men and three women with a mean age of 42 years (range=29–75). Most (N=34) were treated in medical units, 13 were in surgical units, and three were in the neurology service. They had a mean