Baranowski S L, Patten S B
University of Calgary, Alberta.
Can J Psychiatry. 2000 Feb;45(1):75-8. doi: 10.1177/070674370004500111.
To evaluate the predictive value of dysgraphia and constructional apraxia for delirium among psychiatric inpatients.
Data were collected from 2 sources. First, a series of nondelirious psychiatric inpatients that had participated in a previous study was selected to determine the specificity of various indices of dysgraphia and constructional apraxia. Second, a series of 56 psychiatric inpatients with delirium as identified using electronic administrative data and clinical records was selected to evaluate sensitivity.
Of the various indices of dysgraphia examined, only a global rating of writing quality and evidence of jagged or angled letter loops were informative clinical signs. The predictive value of constructional apraxia resembled the predictive value of the 2 dysgraphia indices.
Dysgraphia and constructional apraxia are useful clinical signs of delirium in the psychiatric inpatient population. Evaluation of these functions can substantially impact diagnostic decisions where diagnostic uncertainty exists. An evaluation of writing and constructional praxis can be easily incorporated into bedside mental status examinations.
评估书写障碍和结构性失用症对精神科住院患者谵妄的预测价值。
数据收集自两个来源。首先，选取一系列曾参与过先前研究的非谵妄性精神科住院患者，以确定书写障碍和结构性失用症各项指标的特异性。其次，选取一系列经电子管理数据和临床记录确诊为谵妄的56例精神科住院患者，以评估敏感性。
在所检查的书写障碍各项指标中，只有书写质量的整体评分以及锯齿状或有角度的字母环迹象是具有参考价值的临床体征。结构性失用症的预测价值与书写障碍的两项指标的预测价值相似。
书写障碍和结构性失用症是精神科住院患者谵妄的有用临床体征。对这些功能的评估在存在诊断不确定性的情况下可对诊断决策产生重大影响。书写和结构性实践能力的评估可轻松纳入床边精神状态检查。
