Hayyunah Rohmatul Ahadiah, Lailatus Syadza, Moch Syafirul Nur Shafly, Asikah, Hafid Algristian

Delirium in Bipolar Disorder as a Triggering Factor to Cognitive Decline: A Case Report and Neuroprogression Insight

Introduction

Delirium in bipolar disorder as a triggering factor to cognitive decline: a case report and neuroprogression insight. Case report: Bipolar disorder, delirium, and cognitive decline linked to metabolic comorbidities. Highlights early detection and integrated care to prevent neuropsychiatric deterioration.

Abstract

Bipolar disorder is a major contributor to global disability, affecting not only mood regulation but also cognitive function, and its impact is often exacerbated by metabolic comorbidities such as type 2 diabetes mellitus, hypertension, and dyslipidemia. These comorbid conditions can lead to poorer clinical outcomes and increase the risk of neuropsychiatric complications such as delirium and cognitive impairment, which are frequently overlooked in clinical practice. This article aims to describe and analyze the case of a 31-year-old male with a history of bipolar disorder who presented with a hyperglycemic crisis and pneumonia, followed by the onset of acute delirium and subsequent cognitive decline. Through a descriptive clinical approach, the patient’s medical and psychiatric history, laboratory findings, and treatment course are reviewed to explore the complex interaction between mood disorders and metabolic dysfunction. The analysis reveals a strong link between metabolic dysregulation and worsening neuropsychiatric outcomes. This case underscores the importance of early detection and an integrated, multidisciplinary management approach to prevent long-term cognitive deterioration in patients with psychiatric disorders accompanied by metabolic conditions, offering important implications for future clinical practice.

Review

This case report, titled "Delirium in Bipolar Disorder as a Triggering Factor to Cognitive Decline: A Case Report and Neuroprogression Insight," addresses a critically important and often under-recognized area at the intersection of psychiatry and general medicine. The authors effectively highlight how metabolic comorbidities, prevalent in bipolar disorder, can significantly exacerbate clinical outcomes, leading to complex neuropsychiatric presentations like delirium and subsequent cognitive impairment. The focus on a 31-year-old male presenting with a hyperglycemic crisis and pneumonia, followed by delirium and cognitive decline, provides a compelling real-world example of these intricate interactions, setting the stage for a deeper exploration of neuroprogression in this vulnerable patient population. A notable strength of this work lies in its descriptive clinical approach, meticulously reviewing the patient’s medical and psychiatric history, laboratory findings, and treatment course. This detailed presentation is crucial for understanding the chronological and pathophysiological links proposed. The abstract successfully conveys a strong argument for the profound impact of metabolic dysregulation on worsening neuropsychiatric outcomes, particularly identifying delirium as a potential pivotal event leading to cognitive deterioration. The "neuroprogression insight" suggested in the title is evidently supported by the observed trajectory, offering a valuable perspective on how systemic insults can precipitate long-term brain health issues in individuals with pre-existing psychiatric conditions. While the insights derived from a single case report are inherently limited in their generalizability, this article nonetheless serves as an excellent foundational piece. It powerfully underscores the necessity of early detection and an integrated, multidisciplinary management approach for patients with psychiatric disorders and co-occurring metabolic conditions to mitigate long-term cognitive decline. For the full paper, a deeper discussion on the precise mechanisms linking hyperglycemic crisis, pneumonia, delirium, and subsequent neuroprogression would further enrich its contribution. This work offers significant implications for clinical practice, urging clinicians to adopt a more holistic view of patient care, and provides a clear impetus for larger-scale prospective studies investigating these complex interrelationships.

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