Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychiatry. 2014 Apr;56(2):171-5. doi: 10.4103/0019-5545.130501.
To evaluate the predictors of delay in psychiatry referral for patients with delirium.
The consultation liaison psychiatry registry and case notes of 461 patients referred to psychiatry consultation liaison services and diagnosed as having delirium were reviewed. Data pertaining to sociodemographic variables, clinical variables, Delirium Rating Scale-Revised 98 version, etiologies associated with delirium were extracted.
Older age, presence of and higher severity of sleep disturbance, presence of and higher severity of motor retardation, presence of visuospatial disturbances, presence of fluctuation of symptoms, being admitted to medical ward/medical intensive care units, and absence of comorbid axis-1 psychiatry diagnoses were associated with longer duration of psychiatric referral after the onset of delirium. Of these only four variables (presence of sleep disturbance, presence of motor retardation, being admitted to medical ward intensive care units and absence of comorbid axis-1 psychiatry diagnoses) were associated with longer duration of psychiatric referral in the regression analysis.
The variables associated with delay in psychiatry referral for delirium suggest that there is a need to improve the understanding of the physicians and surgeons about the signs and symptoms, risk factors, and prognostic factors of delirium.
评估精神科转介延误的预测因素。
对 461 例因谵妄而转至精神科会诊联络服务并被诊断为谵妄的患者的会诊联络精神病学登记处和病历进行了回顾。提取了与社会人口学变量、临床变量、修订版 98 版谵妄评定量表、谵妄相关病因有关的数据。
年龄较大、存在睡眠障碍且严重程度较高、存在且运动迟缓程度较高、存在视觉空间障碍、症状波动、入住内科病房/内科重症监护病房、无共病轴 1 精神病学诊断与谵妄发生后精神科转介的时间较长有关。在回归分析中,只有四个变量(存在睡眠障碍、存在运动迟缓、入住内科病房重症监护病房和无共病轴 1 精神病学诊断)与精神科转介时间较长有关。
与谵妄精神科转介延误相关的变量表明,需要提高医生和外科医生对谵妄的症状、风险因素和预后因素的认识。