Sibia Ishrat, Singh Angad H, Joshi Rahul, Khanduja Deepak, Bathla Manish
Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India.
J Family Med Prim Care. 2023 May;12(5):986-989. doi: 10.4103/jfmpc.jfmpc_1655_22. Epub 2023 May 31.
Delirium is an acute confusional state characterized by changes in the mental status, level of consciousness, impaired cognition, and inattention. It can develop within hours or days. Cortisol release from the hypothalamic-pituitary-adrenal axis (HPA) is vital for the host survival in stress. Biomarkers are used as an indicator of pathogenic processes or to assess the responses to a therapeutic intervention. To improve delirium recognition and care, investigators have identified possible biomarkers that may help in diagnosing individuals with delirium, assessing the severity of delirium. Cortisol has been suggested as biomarker for the diagnosis of delirium.
To evaluate and compare levels of serum cortisol in patients with alcohol withdrawal delirium with delirium due to other disorders.
It was a cross-sectional prospective observational study. A total of 30 patients in Group A and 32 in Group B were included. The participants were evaluated based on delirium rating scale (DRS).
It was seen that in alcohol withdrawal delirium group, there was significant positive correlation between DRS score and serum cortisol level, i.e., with increase in DRS score, there was increase in serum cortisol levels and vice versa.
Serum cortisol levels are associated and directly correlate with the occurrence and severity of delirium. Further studies are needed to elucidate the implications of this association for diagnosis and treatment.
谵妄是一种急性意识模糊状态,其特征为精神状态、意识水平改变、认知受损和注意力不集中。它可在数小时或数天内发展。下丘脑 - 垂体 - 肾上腺轴(HPA)释放的皮质醇对宿主在应激状态下的生存至关重要。生物标志物用作致病过程的指标或评估对治疗干预的反应。为了改善谵妄的识别和护理,研究人员已经确定了可能有助于诊断谵妄患者、评估谵妄严重程度的生物标志物。皮质醇已被提议作为谵妄诊断的生物标志物。
评估并比较酒精戒断谵妄患者与其他疾病所致谵妄患者的血清皮质醇水平。
这是一项横断面前瞻性观察研究。共纳入A组30例患者和B组32例患者。根据谵妄评定量表(DRS)对参与者进行评估。
可见在酒精戒断谵妄组中,DRS评分与血清皮质醇水平之间存在显著正相关,即随着DRS评分增加,血清皮质醇水平升高,反之亦然。
血清皮质醇水平与谵妄的发生和严重程度相关且直接相关。需要进一步研究以阐明这种关联对诊断和治疗的意义。