Writing disturbances: an indicator for postoperative delirium.

OBJECTIVE

To study the writing ability pre- and postoperatively in patients undergoing major surgery.

METHOD

In an open study twenty-four consecutive patients undergoing thoracotomy for pulmonary malignancy were monitored for postoperative delirium throughout their stay in the hospital. The writing ability was tested on a preoperative day and on the third day after the operation. Main outcome measures were delirium according to the DSM-III-R criteria and writing ability assessed on items such as reluctance to write and motor-, spatial-, syntactical- and spelling disorders.

RESULTS

Five patients (21%) developed delirium according to the DSM-III-R criteria. The writing of all patients with delirium was severely impaired with features like reluctance to write, motor disability and spatial disturbances. No patient without delirium developed these disturbances.

CONCLUSIONS

These results suggest that testing of writing ability may be useful in the diagnosis of delirium. The Delirium Writing Test is proposed as a diagnostic tool.