Department of Internal Medicine and Psychiatry (Med-Psych), Southern Illinois University School of Medicine, Springfield, IL, USA.
Gen Hosp Psychiatry. 2011 Jul-Aug;33(4):377-85. doi: 10.1016/j.genhosppsych.2011.05.001. Epub 2011 Jun 12.
Factor analytic studies of delirium symptoms among patients referred through consultation-liaison psychiatric services are rare. We examined the factor structure of delirium symptoms in referred patients and determined whether combining items from several delirium rating scales influenced the factor structure of delirium symptoms.
Eighty-six patients with delirium (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) referred though the consultation-liaison services were assessed with structured rating scales. Nineteen symptom items extracted from the Delirium Rating Scale-Revised-98 (DRS-R-98), the Memorial Delirium Assessment Scale and the Confusional State Evaluation Scale were subjected to an exploratory (principal component) factor analysis. A second such analysis was conducted on 15 items of the DRS-R-98 for comparison.
Compared with prior studies, patients were younger and the majority had hyperactive delirium. Principal components analysis identified two factors: (1) a "cognitive" factor comprising of disturbances in language, thought processes, orientation, attention, short- and long-term memory, visuospatial ability, consciousness (awareness) and perseveration accounted for 28.9% of the variance and (2) a "behavioral" factor consisting of sleep-wake cycle disturbances, delusions, perceptual disturbances, motor agitation, affect-lability, distractibility, irritability and temporal onset accounted for 18.9% of the variance. An identical factor structure was obtained with the DRS-R-98 items.
Similar to previous factor analytic studies, the present study supported the existence of two principal dimensions of delirium, cognitive and behavioral. Additionally, it extended the results of earlier investigations to a wider group of patients with delirium, suggesting that these dimensions might provide important clues to the neurobiology of delirium.
通过联络精神病学服务转介的患者的谵妄症状的因子分析研究很少见。我们检验了转介患者谵妄症状的因子结构，并确定了是否合并几种谵妄评定量表的项目会影响谵妄症状的因子结构。
通过联络精神病学服务转介的 86 例谵妄患者（《精神障碍诊断与统计手册》第四版修订版）接受了结构化评定量表的评估。从谵妄评定量表修订版-98 （DRS-R-98）、纪念谵妄评定量表和意识状态评估量表中提取的 19 个症状项目进行了探索性（主成分）因子分析。第二次分析是对 DRS-R-98 的 15 个项目进行的，以进行比较。
与先前的研究相比，患者年龄较小，大多数为活跃型谵妄。主成分分析确定了两个因素：（1）一个“认知”因素，包括语言、思维过程、定向、注意力、短期和长期记忆、视空间能力、意识（意识）和持续存在，占 28.9%的方差；（2）一个“行为”因素，包括睡眠-觉醒周期紊乱、妄想、知觉障碍、运动激越、情感变化、注意力分散、易怒和时间发作，占 18.9%的方差。使用 DRS-R-98 项目也得到了相同的因子结构。
与先前的因子分析研究相似，本研究支持谵妄存在认知和行为两个主要维度。此外，它将早期研究的结果扩展到更广泛的谵妄患者群体，表明这些维度可能为谵妄的神经生物学提供重要线索。
