Features of subsyndromal and persistent delirium

Longitudinal studies of delirium phenomenology are lacking. We studied features that characterise subsyndromal delirium and persistent delirium over time. Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium...

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Published inBritish journal of psychiatry Vol. 200; no. 1; pp. 37 - 44
Main Authors Meagher, David, Adamis, Dimitrios, Trzepacz, Paula, Leonard, Maeve
Format Journal Article
LanguageEnglish
Published Cambridge, UK Cambridge University Press 01.01.2012
Subjects
Adult
Aged
Aged, 80 and over
Agitation
Algorithms
Attention
Benzodiazepines - therapeutic use
Cancer
Cognitive ability
Cognitive impairment
Comorbidity
Delirium
Delirium - diagnosis
Delirium - epidemiology
Delirium - physiopathology
Delusions
Dementia - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Disease Progression
Female
Hallucinations
Humans
Long term memory
Longitudinal Studies
Male
Memory
Middle Aged
Models, Statistical
Mortality
Neuropsychological Tests
Older people
Palliative Care
Phenomenology
Prominence
Prospective Studies
Psychiatry
Severity of Illness Index
Symptoms
Syndrome
Vigilance
Ireland
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Abstract Longitudinal studies of delirium phenomenology are lacking. We studied features that characterise subsyndromal delirium and persistent delirium over time. Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium. Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation. Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
AbstractList Background: Longitudinal studies of delirium phenomenology are lacking. Aims: We studied features that characterise subsyndromal delirium and persistent delirium over time. Method: Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale- Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium. Results: Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation. Conclusions: Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment. Declaration of Interest P.T. is a full-time salaried employee and shareholder at Eli Lilly and Company. Adapted from the source document.
Longitudinal studies of delirium phenomenology are lacking. We studied features that characterise subsyndromal delirium and persistent delirium over time. Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium. Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation. Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
Longitudinal studies of delirium phenomenology are lacking.BACKGROUNDLongitudinal studies of delirium phenomenology are lacking.We studied features that characterise subsyndromal delirium and persistent delirium over time.AIMSWe studied features that characterise subsyndromal delirium and persistent delirium over time.Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium.METHODTwice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium.Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation.RESULTSParticipants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation.Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.CONCLUSIONSFull syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
BackgroundLongitudinal studies of delirium phenomenology are lacking.AimsWe studied features that characterise subsyndromal delirium and persistent delirium over time.MethodTwice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale – Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium.ResultsParticipants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2–9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation.ConclusionsFull syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
BACKGROUND: Longitudinal studies of delirium phenomenology are lacking. Aims We studied features that characterise subsyndromal delirium and persistent delirium over time. METHOD: Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale- Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium. RESULTS: Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation. CONCLUSIONS: Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
Author Trzepacz, Paula
Adamis, Dimitrios
Meagher, David
Leonard, Maeve
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  fullname: Meagher, David
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  organization: Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Milford Hospice Palliative Care Centre, Limerick and University of Limerick Medical School, Limerick, Ireland
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  surname: Trzepacz
  fullname: Trzepacz, Paula
  organization: Lilly Research Laboratories, Indianapolis, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA
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  givenname: Maeve
  surname: Leonard
  fullname: Leonard, Maeve
  organization: Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Milford Hospice Palliative Care Centre, Limerick and University of Limerick Medical School, Limerick, Ireland
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22075650$$D View this record in MEDLINE/PubMed
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Snippet Longitudinal studies of delirium phenomenology are lacking. We studied features that characterise subsyndromal delirium and persistent delirium over time....
BackgroundLongitudinal studies of delirium phenomenology are lacking.AimsWe studied features that characterise subsyndromal delirium and persistent delirium...
Longitudinal studies of delirium phenomenology are lacking.BACKGROUNDLongitudinal studies of delirium phenomenology are lacking.We studied features that...
BACKGROUND: Longitudinal studies of delirium phenomenology are lacking. Aims We studied features that characterise subsyndromal delirium and persistent...
Background: Longitudinal studies of delirium phenomenology are lacking. Aims: We studied features that characterise subsyndromal delirium and persistent...
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SubjectTerms Adult
Aged
Aged, 80 and over
Agitation
Algorithms
Attention
Benzodiazepines - therapeutic use
Cancer
Cognitive ability
Cognitive impairment
Comorbidity
Delirium
Delirium - diagnosis
Delirium - epidemiology
Delirium - physiopathology
Delusions
Dementia - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Disease Progression
Female
Hallucinations
Humans
Long term memory
Longitudinal Studies
Male
Memory
Middle Aged
Models, Statistical
Mortality
Neuropsychological Tests
Older people
Palliative Care
Phenomenology
Prominence
Prospective Studies
Psychiatry
Severity of Illness Index
Symptoms
Syndrome
Vigilance
Title Features of subsyndromal and persistent delirium
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