Webster R, Holroyd S
Department of Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Psychosomatics. 2000 Nov-Dec;41(6):519-22. doi: 10.1176/appi.psy.41.6.519.
Psychosis in delirium has been an underresearched area. The authors retrospectively examined the prevalence of psychotic symptoms and possible associated factors in the records of 227 consecutive hospitalized patients. These patients had been diagnosed with delirium, according to the DSM-IV criteria and referred to a psychiatry consult service. The authors compared patients, with or without psychosis, on demographic variables, medical and psychiatric history; number of medications, etiology of delirium, and cognitive state. The prevalence of psychotic symptoms was 42.7% (n = 97) with 27% of patients (n = 61) having visual hallucinations, 12.4% (n = 28) having auditory hallucinations, 2.7% (n = 6) having tactile hallucinations, and 25.6% (n = 58) having delusions. The presence of visual hallucinations, but not delusions or auditory hallucinations, was significantly associated with more active medical diagnoses and multiple etiologies causing the delirium. Psychotic symptoms are not uncommon in delirium, but specific psychotic symptoms may have different factors contributing to their development. Visual hallucinations appear to be associated with a greater number of active medical disorders, but other factors associated with the development of psychotic symptoms in delirium are currently unknown.
谵妄中的精神病一直是一个研究不足的领域。作者回顾性地检查了227例连续住院患者病历中精神病性症状的患病率及可能的相关因素。这些患者根据《精神疾病诊断与统计手册》第四版标准被诊断为谵妄，并被转介至精神科会诊服务。作者比较了有或无精神病的患者在人口统计学变量、医学和精神病史、用药数量、谵妄病因及认知状态方面的情况。精神病性症状的患病率为42.7%（n = 97），其中27%的患者（n = 61）有视幻觉，12.4%（n = 28）有听幻觉，2.7%（n = 6）有触幻觉，25.6%（n = 58）有妄想。视幻觉的存在与更活跃的医学诊断及导致谵妄的多种病因显著相关，而非妄想或听幻觉。精神病性症状在谵妄中并不罕见，但特定的精神病性症状可能有不同的促发因素。视幻觉似乎与更多活跃的医学疾病相关，但目前尚不清楚与谵妄中精神病性症状发展相关的其他因素。
