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Abstract
Objective: To compare the symptoms of delirium as assessed by the Delirium Rating Scale-Revised-98 (DRS-R-98) and associated aetiologies in adult and elderly patients seen in a consultation-liaison service.
Methods: A total of 321 consecutive patients with a DSM-IV-TR diagnosis of delirium were assessed on the DRS-R-98 and a study-specific aetiology checklist.
Results: Of the 321 patients, 245 (76%) aged 18 to 64 years formed the adult group, while 76 (24%) formed the elderly group (> 65 years). The prevalence and severity of various symptoms of delirium as assessed using the DRS-R-98 were similar across the 2 groups, except for the adult group having statistically higher prevalence and severity scores for thought process abnormalities and lability of affect. For both groups and the whole sample, factor analysis yielded a 3-factor model for the phenomenology. In the 2 groups, the DRS-R-98 item loadings showed subtle differences across various factors. The 2 groups were similar for the mean number of aetiologies associated with delirium, the mean number being 3. However, the 2 groups differed with respect to hepatic derangement, substance intoxication, withdrawal, and postpartum causes being more common in the adult group, in contrast lung disease and cardiac abnormalities were more common in the elderly group.
Conclusion: Adult and elderly patients with delirium are similar with respect to the distribution of various symptoms, motor subtypes, and associated aetiologies.
Key words: Delirium; Syndrome
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Introduction
Even though delirium is a common clinical entity, diagnosing and managing those affected can be extremely challenging due to its broad-based phenomenology. Thus, a clearer delineation of phenomenology can improve the diagnosis and management of delirium.
Factor analysis is a tool extensively used to delineate the phenomenology of delirium.115 In the hope that this will help to unravel pathophysiology and indicate better treatment approaches, factor analysis has been used to determine correlations among symptoms and to cluster individual symptoms to generate symptom-based subgroups.16 The existing research in this field is limited to the elderly,1414 critically ill,56 those with malignancies,1012 and those seen in consultation-liaison (CL) services.1215 Many of these research studies were compromised by their small sample sizes.2 49
Two types of symptoms have been delineated for delirium. One refers to the 'core' symptoms /...