In Pursuit of Consensus: Excited Delirium Syndrome (ExDS)

“In Pursuit of Inter‐Specialty Consensus on Excited Delirium Syndrome: a Scoping Literature Review" was published Nov. 9, 2022 in the Journal of Forensic Science, Medicine, and Pathology.

Excited Delirium Syndrome (ExDS), a hotly debated diagnosis, has been discussed related to the recent high-profile murders of Elijah McClain and George Floyd. For this article, a comprehensive search was built and conducted by MCW medical librarian Eric Harding in several databases, including Ovid Medline, PsycINFO, and Scopus.

Most studies (74%) discussed ExDS symptom profiles. Forty-three percent reported on ExDS-related deaths, and 33% on restraint deaths in custody.

MCW authors Matthew Fiorillo, DO, psychiatry resident PGY 3; Julie Owen, MD, assistant professor of psychiatry and behavioral medicine; Ruby Long, MD, clinical assistant professor of emergency medicine; and Ian Martin, MD, MBA, chair and professor of emergency medicine, reviewed ExDS deaths and police-related deaths in-custody, demonstrating the poor outcomes which result from pre-hospital diagnosis and treatment, at times from non-medical professionals.

The authors call for consensus on diagnosis, consideration of a new name or re-categorization of ExDS, and cessation of utilization of this diagnosis independently as rationale for restraint.

This project was a true multi-institutional effort, and the team would like to thank Sarah Slocum, MD, Geisel School of Medicine, for her exceptional organization and vision throughout. The team also thanks MCW reference librarian Rita Sieracki for her time and expertise.