Symptom Profile and Etiology of Delirium in a Referral Population in Northern India: Factor Analysis of the DRS–R98

• Published in: The journal of neuropsychiatry and clinical neurosciences Vol. 24; no. 1; pp. 95 - 101
• Main Authors: Mattoo, Surendra K, Grover, Sandeep, Chakravarty, Kaustav, Trzepacz, Paula T, Meagher, David J, Gupta, Nitin
• Format: Journal Article
• Language: English
• Published: Arlington, VA American Psychiatric Publishing, Inc 2012; American Psychiatric Publishing
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Attention Deficit Disorder with Hyperactivity - etiology; Biological and medical sciences; Circadian Rhythm - physiology; Cognition Disorders - etiology; Consent; Delirium; Delirium - complications; Delirium - epidemiology; Delirium - etiology; Dementia; Developing countries; Diagnostic and Statistical Manual of Mental Disorders; Factor Analysis, Statistical; Female; Hospitalization; Human subjects; Humans; India - epidemiology; LDCs; Male; Medical sciences; Middle Aged; Mortality; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Perceptual Disorders - etiology; Phenomenology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Referral and Consultation; Severity of Illness Index; Sleep; Sleep Wake Disorders - etiology; Studies; Teaching hospitals; Tumors; Visual Perception - physiology; Young Adult; Asia; India; Delirium; Symptomatology; Factor analysis; Etiology; Clinical form; Mental confusion; Organic mental disorder
• ISSN: 0895-0172; 1545-7222; 1545-7222
• DOI: 10.1176/appi.neuropsych.11010009

Delirium is understudied in developing countries, where there tends to be a lower proportion of older persons and comorbid dementia. The authors assessed 100 consecutive cases of DSM-IV delirium (patients' mean age: 44.4 [standard deviation: 19.4] years; mean DRS–R98 score: 25.6 [3.6]) referred to an adult Consultation–Liaison Psychiatry service in Northern India. Disturbances of attention, orientation, visuospatial ability, and sleep disturbance were the most frequent symptoms, followed by language, thought-process abnormality, and motor agitation. A three-factor solution was identified, representing domains for cognition, higher-order thinking, and circadian rhythm/psychosis. These domains can guide studies addressing the relationship between symptom profile, therapeutic needs, and outcomes and are consistent with core domains previously identified in other countries.