Levkoff Sue E, Liptzin Benjamin, Cleary Paul D, Wetle Terrie, Evans Denis A, Rowe John W, Lipsitz Lewis A
Harvard Medical School, Boston, MA.
Am J Geriatr Psychiatry. 1996;4(4):320-329. doi: 10.1097/00019442-199622440-00006. Epub 2012 Aug 15.
The authors sought to determine whether subsyndromal delirium is a qualitatively distinct clinical entity or a spectrum of cognitive and behavioral abnormalities. They conducted a prospective, longitudinal study on 325 patients in an acute care hospital with 3- and 6-month follow-ups. Patients were classified into one of three groups: those meeting full DSM criteria for delirium, those with subsyndromal delirium, and those with no symptoms of delirium. There were no differences in risk factors between those developing DSM-defined delirium or subsyndromal delirium. Number of independent risk factors was a significant predictor of delirium. Patients with subsyndromal delirium fall on a continuum between those with DSM-defined delirium and those with no symptoms of delirium. These data suggest that delirium does represent a spectrum of neurobehavioral impairment. Patients with symptoms of subsyndromal delirium are at risk for considerable morbidity; therefore clinicians should attempt to reduce and treat the onset of occurrence of subsyndromal delirium.
作者试图确定亚综合征谵妄是一种性质上不同的临床实体，还是一系列认知和行为异常。他们对一家急症医院的325名患者进行了一项前瞻性纵向研究，并进行了3个月和6个月的随访。患者被分为三组之一：符合谵妄的完整DSM标准的患者、患有亚综合征谵妄的患者和没有谵妄症状的患者。发生DSM定义的谵妄或亚综合征谵妄的患者之间的危险因素没有差异。独立危险因素的数量是谵妄的一个重要预测指标。患有亚综合征谵妄的患者处于DSM定义的谵妄患者和没有谵妄症状的患者之间的连续体上。这些数据表明，谵妄确实代表了一系列神经行为损害。有亚综合征谵妄症状的患者有相当高的发病风险；因此，临床医生应尝试减少和治疗亚综合征谵妄的发生。
