Sharma Arvind
Student, Department of Psychiatry, Guru Gobind Singh Medical College and Hospital , Faridkot, Punjab, India .
Professor and Head, Department of Psychiatry, Guru Gobind Singh Medical College and Hospital , Faridkot, Punjab, India .
J Clin Diagn Res. 2016 Aug;10(8):VC01-VC05. doi: 10.7860/JCDR/2016/20267.8260. Epub 2016 Aug 1.
Delirium is an acute and often fluctuating disturbance in level of consciousness and thought process (cognition) that develops over a short period of time and is a significant change from previous level of functioning. Its prevalence increases with age, complexity of medical co- morbidities and number of medications prescribed.
To compare the cause and severity of delirium in patients in emergency and consultation liaison psychiatry group.
A cross-sectional, tertiary care hospital based study was conducted on the patients who presented with delirium from emergency department (50) and consultation-liaison psychiatry groups (50), over a period of one year. The diagnosis was made on the basis of DSM- 5 criteria. The Delirium Rating Scale (DRS-R-98) was applied to know the severity of delirium, cognitive and non-cognitive symptoms of delirium in patients. The results were subjected to appropriate statistical analysis.
In emergency group, 42% patients had metabolic abnormalities, while in consultation-liaison, 38% patients had hyponatremia and hypokalemia and the difference was found to be statistically non-significant (p>0.05). In emergency group, 21(42%) patients were diagnosed as delirium due to other medical condition, followed by 13 (26%) and 8(16%) patients, who were diagnosed as delirium due to multiple aetiologies and substance intoxication each respectively. In only 33(66%) cases in consultation liaison group patients had delirium secondary to other medical conditions. As per DRS-R98 Scale, mean severity score was found to be statistically significant (p<0.05) in consultation liaison group as compared to emergency department group (p> 0.05).
Delirium is multifactorial aetiological disease, with variable but preventable outcome. Approach should be aimed at finding the treatable causes to reduce morbidity and mortality.
谵妄是一种急性且常呈波动的意识水平和思维过程（认知）障碍，在短时间内发展，是与先前功能水平的显著变化。其患病率随年龄、合并症的复杂性以及所开药物数量的增加而升高。
比较急诊科和会诊联络精神病学组患者谵妄的病因及严重程度。
在一家三级护理医院进行了一项横断面研究，研究对象为在一年时间内来自急诊科（50例）和会诊联络精神病学组（50例）出现谵妄的患者。诊断依据DSM - 5标准。应用谵妄评定量表（DRS - R - 98）了解患者谵妄的严重程度、认知和非认知症状。对结果进行适当的统计分析。
在急诊科组，42%的患者有代谢异常，而在会诊联络组，38%的患者有低钠血症和低钾血症，差异无统计学意义（p>0.05）。在急诊科组，21例（42%）患者因其他医疗状况被诊断为谵妄，其次分别有13例（26%）和8例（16%）患者因多种病因和物质中毒被诊断为谵妄。在会诊联络组中，仅33例（66%）患者的谵妄继发于其他医疗状况。根据DRS - R98量表，会诊联络组的平均严重程度得分与急诊科组相比有统计学意义（p<0.05），而急诊科组差异无统计学意义（p>0.05）。
谵妄是一种多因素病因的疾病，预后可变但可预防。治疗方法应旨在找出可治疗的病因以降低发病率和死亡率。
