Delirium phenomenology: What can we learn from the symptoms of delirium?

被引:79
作者
Gupta, Nitin [1 ]
de Jonghe, Jos [2 ]
Schleveld, Jan [3 ]
Leonard, Maeve [4 ]
Meagher, David [5 ]
机构
[1] S Staffordshire & Shropshire Hlth NHS Fdn Trust, Burton Upon Trent, England
[2] Med Ctr Alkmaar, Dept Geriat Med, Alkmaar, Netherlands
[3] Maastricht Univ, Med Ctr, Div Child & Adolescent Psychiat, Dept Psychiat & Neuropsychol, Maastricht, Netherlands
[4] Limerick Reg Hosp, Limerick, Ireland
[5] Univ Limerick, Midwestern Reg Hosp, Hlth Syst Res Ctr, Dept Psychiat, Limerick, Ireland
关键词
delirium; phenomenology;
D O I
10.1016/j.jpsychores.2008.05.020
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objectives: This review focuses on phenomenological studies of delirium, including subsyndromal and prodromal concepts, and their relevance to other elements of clinical profile. Methods: A Medline search using the keywords delirium, phenonienology, and symptoms for new data articles published in English between 1998 and 2008 was utilized. The search was supplemented by additional material not identified by Medline but known to the authors. Results: Understanding of prodromal and subsyndromal concepts is still in its infancy. The characteristic profile can differentiate delirium from other neuropsychiatric disorders. Clinical (motoric) subtyping holds potential but more consistent methods are needed. Studies are almost entirely cross-sectional in design and generally lack comprehensive symptom assessment. Multiple assessment tools are available but are oriented towards hyperactive features and few have demonstrated ability to distinguish delirium from dementia. There is insufficient evidence linking specific phenomenology with etiology, pathophysiology, management, course, and outcome. Conclusions: Despite the major advancements of the past decade in many aspects of delirium research, further phenomenological work is crucial to targeting Studies of causation, pathophysiology, treatment, and prognosis. We identified eight key areas for future studies. (c) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:215 / 222
页数:8
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