An Empirical Study of Delirium Subtypes

  title={An Empirical Study of Delirium Subtypes},
  author={Benjamin Liptzin and Sue E. Levkoff},
  journal={British Journal of Psychiatry},
  pages={843 - 845}
Using a structured instrument, 325 elderly patients admitted to a general hospital for an acute medical problem were evaluated daily in order to detect symptoms of delirium. Patients were scored for ‘hyperactive’ or ‘hypoactive’ symptoms, and then the 125 patients with DSM–III delirium were rated as ‘hyperactive type’ (15%), ‘hypoactive type’ (19%), ‘mixed type’ (52%), or ‘neither’ (14%). There were no statistically significant differences between the groups with respect to age, sex, place of… 
Delirium in hospitalised older persons: Review
Delirium is reviewed, which has all the features of an important geriatric syndrome: it appears mainly in persons older than 65 years of age, is closely linked with very prevalent diseases and complications arising in the elderly, and is the mode of presentation of many other diseases in this age group.
The wave called delirium, from onset to consequences
The research in this thesis was done in a homogeneous group with baseline data available, as well as longitudinal and follow-up data on several factors, to increase knowledge on several aspects of delirium: predisposing and precipitating factors (anesthetic technique, surgery), phenomenology and symptoms throughout theDelirium episode (motor subtyping), and conclude with the (long-term) outcomes of Delirium (cognitive and affective functioning).
Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium
Hypoactive and mixed subtypes were significantly more frequent in delirious patients andRegression analysis showed that hypoactive subtype was significantly associated with lower MoCA, and no relationship between motor subtypes and mortality was found.
Etiologic and Outcome Profiles in Hypoactive and Hyperactive Subtypes of Delirium
The presence of acute metabolic disorders, cardiovascular disease, and hyperthermia as etiologic factors was significantly associated with full recovery of the episode at 3 weeks follow-up, whereas probable preexisting dementia was significant associated with partial recovery or failure to recover.
Delirium in the primary care setting
A retrospective chart review was carried out for the identification of ICD‐10 delirium cases presented in the regional medical office of a rural area in central Greece, finding that elderly and suffering from dementia were the underlying cause in most cases.
Clinical significance of delirium subtypes in older people.
Patients with hypoactive delirium were sicker on admission, had the longest hospital stay and were most likely to develop pressure sores and fall in hospital, while patients with hyperactive delIRium were mostlikely toFall in hospital.
Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia.
Delirium Definitions and Subtypes
Using clear definitions of delirium in the literature will allow further study of this highly prevalent and clinically significant syndrome.
Relationship between symptoms and motoric subtype of delirium.
Delirium presents as motoric subtypes that differ according to symptom profile and severity of delirium, and these subtypes may differ in their underlying pathophysiologies, responsiveness to therapeutic interventions, and outcome.


An empirical study of diagnostic criteria for delirium.
The development of new criteria for delirium (e.g., DSM-IV) will have to balance the need to define a pure group of patients for research purposes with the need for cases of clinical interest.
A prospective study of delirium in hospitalized elderly.
The increased mortality associated with delirium appears to be explained by greater severity of illness, and identifies elderly at risk for death, longer hospitalization, and institutionalization.
Review of research instruments and techniques used to detect delirium.
An overview of instruments used in studies of delirium is provided and the rationale for the development of the Delirium Symptom Interview is presented, an instrument constructed for use in the Commonwealth-Harvard Study ofDelirium in elderly hospitalized patients.
The Delirium Symptom Interview: An Interview for the Detection of Delirium Symptoms in Hospitalized Patients
Results indicate that the DSI could be used by lay interviewers to assess reliably the symptoms of delirium.
Delirium (acute confusional states).
Acute onset of a fluctuating level of awareness, accompanied by sleep-wake cycle disruption, lethargy or agitation, and nocturnal worsening of symptoms, are diagnostic.
Epidemiology of Delirium: An Overview of Research Issues and Findings
A discussion of the design and preliminary results of the Commonwealth-Harvard Study of Delirium in Elderly Hospitalized Patients documents both how the authors responded to the methodological issues outlined and how these choices influenced their findings.
Transient cognitive disorders (delirium, acute confusional states) in the elderly.
  • Z. J. Lipowski
  • Psychology, Medicine
    The American journal of psychiatry
  • 1983
The author discusses clinical features, etiology, pathogenesis, diagnosis, and treatment of delirium and related transient disorders of cognition in the elderly.
The development of DSM-IV.
The background for the decision to publish DSM-IV in 1993, the rationale for beginning this work in 1988, and the procedural safeguards the authors have instituted to minimize arbitrary and idiosyncratic revisions are provided.
The delirium symptom interview : an interview for the detection of delirium in hospitalized patients
  • Journal of Geriatric Psychiatry and Neurology
  • 1992
Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised)(DSM-IlI-R)
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  • 1987