How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients

被引：9

作者：

Glynn, Kevin ^{[1
]}

McKenna, Frank ^{[1
]}

Lally, Kevin ^{[1
]}

O'Donnell, Muireann ^{[1
]}

Grover, Sandeep ^{[2
]}

Chakrabarti, Subho ^{[2
]}

Avasthi, Ajit ^{[2
]}

Mattoo, Surendra K. ^{[2
]}

Sharma, Akhilesh ^{[2
]}

Ghosh, Abhishek ^{[2
]}

Shah, Ruchita ^{[2
]}

Hickey, David ^{[1
]}

Fitzgerald, James ^{[3
,4
]}

Davis, Brid ^{[5
]}

O'Regan, Niamh ^{[6
]}

Adamis, Dimitrious ^{[7
]}

Williams, Olugbenja ^{[1
]}

Awan, Fahad ^{[1
]}

Dunne, C. ^{[5
]}

Cullen, Walter ^{[8
]}

McInerney, Shane ^{[9
]}

McFarland, John ^{[10
]}

Jabbar, Faiza ^{[9
]}

O'Connell, Henry ^{[11
]}

Trzepacz, Paula T. ^{[12
,13
]}

Leonard, Maeve ^{[1
]}

Meagher, David ^{[1
,5
]}

机构：

[1] Univ Hosp Limerick, Dept Psychiat, Limerick, Ireland

[2] Post Grad Inst Med Educ & Res, Chandigarh, India

[3] Univ Cambridge, Sch Clin Med, Dept Psychiat, Cambridge, England

[4] Cambridgeshire & Peterborough MIS Fdn Trust, Cambridge, England

[5] Univ Limerick, Grad Entry Med Sch, Limerick, Ireland

[6] Cork Univ Hosp Grp, Cork, Ireland

[7] Sligo Gen Hosp, Sligo, Ireland

[8] UCD, Sch Med, Dublin, Ireland

[9] Univ Hosp Galway, Galway, Ireland

[10] Ennis Gen Hosp, Clare Mental Hlth Serv, Clare, Ireland

[11] Univ Hosp Limerick, Dooradoyle, Ireland

[12] Lilly Res Labs, Indianapolis, IN USA

[13] Indiana Univ Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA

来源：

BMJ OPEN | 2021年 / 11卷 / 04期

关键词：

ACUTE CONFUSIONAL STATES; SYMPTOM PROFILE; SCALE; REVERSIBILITY; HALOPERIDOL; MEDICATION;

D O I：

10.1136/bmjopen-2020-041214

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology. Design Cross-sectional study. Setting International study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings. Participants 1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV). Primary and secondary outcome measures Hyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory. Results Hypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001). Conclusions This study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.

引用

页数：9

共 46 条

[1]

Agresti A., 2013, CATEGORICAL DATA ANA, V341, P384

[2]

Albert M S, 1992, J Geriatr Psychiatry Neurol, V5, P14

[3]

American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), V5th, DOI DOI 10.1176/APPI.BOOKS.9780890425596

[4]

Davis B., 2018, THESIS U LIMERICK IR

[5] MMSE items that predict incident delirium and hypoactive subtype in older medical inpatients [J].