Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland.
Psychosomatics. 2009 Sep-Oct;50(5):506-14. doi: 10.1176/appi.psy.50.5.506.
Delirium occurs in approximately 1 in 5 general hospital admissions and up to 85% of patients with terminal illness, but can be difficult to differentiation from other disorders, such as depression.
The authors assessed and compared mood states as they relate to onset of delirium.
Symptoms of depression and delirium were assessed in 100 consecutive palliative-care admissions immediately after admission and 1 week later.
Overall, 51% experienced either major depression or delirium. Most patients with syndromal delirium also met criteria for major depressive illness, and 50% of those with depression had delirium or subsyndromal delirium (SSD). Delirium symptoms were less common in patients with major depression than depressive symptoms in patients with delirium or SSD.
Delirium should be considered in patients with altered mood states, and screening for depression should initially rule out delirium. Sustained alterations in mood may be more frequent in delirium than previously recognized.
谵妄发生在大约五分之一的普通医院入院患者和多达 85%的终末期疾病患者中，但可能难以与其他疾病（如抑郁症）区分。
作者评估和比较了与谵妄发作相关的情绪状态。
在 100 名连续的姑息治疗入院患者入院后立即和一周后评估抑郁和谵妄的症状。
总体而言，51%的患者经历了重度抑郁症或谵妄。大多数有综合征性谵妄的患者也符合重度抑郁障碍的标准，而 50%的抑郁症患者有谵妄或亚综合征性谵妄（SSD）。与有 SSD 或谵妄的患者相比，有重度抑郁症的患者的谵妄症状较少。
应在有情绪状态改变的患者中考虑谵妄，且对抑郁症的筛查应首先排除谵妄。与之前的认识相比，在谵妄中，情绪持续改变可能更为常见。
