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Br J Psychiatry ; 205(6): 478-85, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25359923

ABSTRACT

Background The frequency of full syndromal and subsyndromal delirium is understudied. Aims We conducted a point prevalence study in a general hospital. Method Possible delirium identified by testing for inattention was evaluated regarding delirium status (full/subsyndromal delirium) using categorical (Confusion Assessment Method (CAM), DSM-IV) and dimensional (Delirium Rating Scale-Revised-98 (DRS-R98) scores) methods. Results In total 162 of 311 patients (52%) screened positive for inattention. Delirium was diagnosed in 55 patients (17.7%) using DSM-IV, 52 (16.7%) using CAM and 58 (18.6%) using DRS-R98⩾12 with concordance for 38 (12.2%) individuals. Subsyndromal delirium was identified in 24 patients (7.7%) using a DRS-R98 score of 7-11 and 41 (13.2%) using 2/4 CAM criteria. Subsyndromal delirium with inattention (v. without) had greater disturbance of multiple delirium symptoms. Conclusions The point prevalence of delirium and subsyndromal delirium was 25%. There was modest concordance between DRS-R98, DSM-IV and CAM delirium diagnoses. Inattention should be central to subsyndromal delirium definitions.


Subject(s)
Mass Screening , Symptom Assessment/methods , Aged , Aged, 80 and over , Confusion/diagnosis , Confusion/etiology , Cross-Sectional Studies , Delirium/complications , Delirium/diagnosis , Delirium/epidemiology , Delirium/psychology , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Ireland/epidemiology , Male , Mass Screening/methods , Mass Screening/standards , Mass Screening/statistics & numerical data , Middle Aged , Neuropsychological Tests/standards , Neuropsychological Tests/statistics & numerical data , Patient Acuity , Prevalence , Psychiatric Status Rating Scales , Tertiary Care Centers/statistics & numerical data
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