Clinical Course of Postoperative Psychiatric Disorder in 145 Cases

We reviewed postoperative psychiatric disorder (PPD) occurred in 145 patients operated on at the department to clarify the clinical feature of the PPD, which creates a common problem in the general surgery. The PPDs occurred on the 2.7±0.3 post operative day, persisted for 3.3±0.4 days, and then almost all cases (98.6%) recovered spontaneously. Postoperative insomnia preceded PPDs in 67.6% of cases. During the clinical course excitement was noted in 41.4% of patients and hallucination was noted or presumed in 61.4%. Loss of impressibility or confabulation was found in 34.5%, and disorientation in 29.0%. Intentional self removal of the tubes or attempt was noted in 37.9%. The PPDs seem to be mainly composed of delirium. Although prognosis of postoperative delirium is thought to be good, accompanying accidents such as self-removal of important tubes may result in a significant postoperative complications. Background mechanism of the PPDs is perhaps complicated and obscure, therefore, a definitive and directly effective treatment against the PPDs is not known. Main aim of the treatment of the PPDs is in the improvement of the spatial, mental and physical environment of the ill-patient and family, as if waiting for the storm to pass off.