Grover S, Agarwal M, Sharma A, Mattoo S K, Avasthi A, Chakrabarti S, Malhotra S, Kulhara P, Bas D
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
East Asian Arch Psychiatry. 2013 Jun;23(2):56-64.
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.
目的。比较谵妄评定量表修订版98（DRS-R-98）所评估的谵妄症状，以及在会诊联络服务中所见成年和老年患者的相关病因。方法。对321例连续的符合《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）谵妄诊断标准的患者进行DRS-R-98评估，并使用一项针对该研究的病因清单进行评估。结果。在这321例患者中，245例（76%）年龄在18至64岁之间，构成成年组，而76例（24%）构成老年组（≥65岁）。使用DRS-R-98评估的谵妄各种症状的患病率和严重程度在两组中相似，但成年组在思维过程异常和情感不稳定方面的患病率和严重程度得分在统计学上更高。对于两组和整个样本，因子分析得出了一个关于现象学的三因子模型。在两组中，DRS-R-98项目在各个因子上的载荷显示出细微差异。两组与谵妄相关的病因平均数量相似，平均为3个。然而，两组在以下方面存在差异：肝脏紊乱、物质中毒、戒断以及产后病因在成年组中更常见，相比之下，肺部疾病和心脏异常在老年组中更常见。结论。成年和老年谵妄患者在各种症状的分布、运动亚型以及相关病因方面相似。
