Abstract：
Excited delirium syndrome (ExDS) is a controversial and disputed diagnosis involving altered mentation, agitation, and, frequently, substance abuse. Recently, it has become a common pre-hospital diagnosis, serving as justification for use of force, restraint, and/or medication administration. To conduct a scoping review across three databases to describe the most frequently reported diagnostic criteria for ExDS, as well as to explore its use as a diagnosis for deaths of individuals in the custody of law enforcement. In 2021, three literature databases were searched: Ovid Medline, PsycInfo, and Scopus. Studies were included if they were peer-reviewed, English articles describing (1) ExDS symptoms, (2) substance intoxication with at least 2 ExDS symptoms present, or (3) centering on deaths occurring in the custody of law enforcement and attributed to ExDS. Key study data were extracted and the current literature was described qualitatively. Analysis took place between March and December 2021. A total of 97 studies were identified through initial abstract and secondary full-text review, with noted discrepancies in the definition of ExDS itself. After review, differences in ExDS diagnosis among organizations were explored, along with subsequent clinical impact, particularly in the pre-hospital setting. Resulting impact on patients, particularly those of minoritized ethnic and racial groups, was also noted. Prone aggressive restraint, in particular, is noted as an established risk factor for fatalities in ExDS cases. At this time, ExDS should not be utilized as a diagnosis; major medical organizations have an urgent responsibility to convene to formalize consensus-based diagnostic criteria or to propose alternate management guidelines for agitated and altered persons.
摘要：
兴奋性谵妄综合征（ExDS）是一个有争议和有争议的诊断，涉及改变的心理状态，激动,and,经常,药物滥用。最近,它已经成为一种常见的院前诊断，作为使用武力的理由，克制,和/或药物施用。对三个数据库进行范围审查，以描述最常报告的ExDS诊断标准，以及探索将其用作执法机构拘留的个人死亡的诊断。2021年，搜索了三个文献数据库：OvidMedline，PsycInfo,还有Scopus.如果是同行评审的研究，英文文章描述（1）ExDS症状，（2）存在至少2种ExDS症状的物质中毒，或(3)以执法部门监护期间发生的死亡为中心，并归因于ExDS。提取了关键研究数据，并对现有文献进行了定性描述。分析发生在2021年3月至12月之间。通过初始摘要和二次全文回顾，共确定了97项研究，在ExDS本身的定义中存在明显的差异。审查后,探讨了组织间ExDS诊断的差异，以及随后的临床影响，特别是在院前设置。对患者产生影响，特别是那些少数民族和种族群体，也注意到了。倾向于侵略性的克制，特别是,被认为是ExDS病例中死亡的既定风险因素。此时,ExDS不应被用作诊断；主要医疗机构有紧急责任召开会议，正式制定基于共识的诊断标准，或为激动和改变的人提出替代管理指南。
