Defining delirium for the International Classification of Diseases, 11th Revision

Meagher, David; MacLullich, Alasdair M.J.; Laurila, Jouko

doi:10.1016/j.jpsychores.2008.05.015

Cited by 49 publications

(42 citation statements)

References 58 publications

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“…These findings indicate that motor disturbances are almost invariable over the course of an episode and especially where delirium reaches full-syndromal severity as measured on the DRS-R98. This supports the notion that motor disturbances are not only core features of delirium but may also be useful markers for delirium detection and warrant greater recognition within classification systems such as the ICD-11 and DSM-V [25]. The status of mixed motor subtype has been uncertain -the category was added to the original hypoactive vs. hyperactive dichotomy in recognition that a significant percentage of patients exhibit features of both hypoactive and hyperactive delirium within short time frames [26].…”

Section: Discussionmentioning

confidence: 55%

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

Meagher

Leonard

Donnelly³

et al. 2012

Journal of Psychosomatic Research

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104

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Section: Discussionmentioning

confidence: 55%

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

Meagher

Leonard

Donnelly³

et al. 2012

Journal of Psychosomatic Research

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104

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“…Unfortunately, differentiating symptoms other than inattention and temporal course are not emphasised in DSM-IV and ICD-10 delirium definitions, whereas disorganised thinking and sleep-wake cycle disturbance were emphasised in the DSM-III-R. Our data support their reinclusion in DSM-V. Providing better guidance regarding the distinction of delirium from dementia—and dementia from delirium—is a key challenge for future definitions of delirium in DSM-V20 and ICD-11 35…”

Section: Discussionmentioning

confidence: 69%

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

Meagher

Leonard

Donnelly³

et al. 2010

Journal of Neurology, Neurosurgery & Psychiatry

102

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Purpose: Delirium and dementia have overlapping features that complicate differential diagnosis. Delirium symptoms overshadow dementia symptoms when they co-occur, but delirium phenomenology in comorbid cases has not been compared to both conditions alone. Methods:Consecutive adults with DSM-IV delirium, dementia, comorbid deliriumdementia, and cognitively intact controls were assessed using the Revised Delirium Rating Scale (DRS-R98) and Cognitive Test for Delirium (CTD).Results : Delirium and comorbid delirium-dementia groups had comparable DRS-R98 and CTD total scores which were greater than in dementia or control groups.On the DRS-R98, multiple non-cognitive symptoms, inattention and disorientation were more severe in delirium groups compared with dementia-alone. Patients with dementia differed from both delirium groups on the CTD test of attention. Spatial span backwards was significantly lower in all patients with cognitive impairment (delirium, comorbid delirium-dementia, dementia alone) compared to controls, whereas spatial span forwards distinguished delirium groups from dementia. Conclusions:Delirium phenomenology is similar with or without comorbid dementia. A wide range of neuropsychiatric symptoms distinguish delirium from dementia. Spatial span forward is disproportionately diminished in delirium , suggesting usefulness as a differentiating screening test. Declaration of interest:The authors wish to acknowledge the support and cooperation of nursing and medical staff at Milford Hospice Palliative care centre.

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“…In a careful diagnostic assessment, an appropriate care should be combined to meet the needs of patients with different clinical perspectives and disease burden. In spite of significant advancements in many aspects of delirium research, more effort is necessary to reach an agreement between the varying definitions in internationally recognized classification systems [97]. Also there is an unrgent need to clarify in a more detailed way the causation, pathophysiology, assessment, treatment, and prognosis of this syndrome in both the general hospital [98] and palliative care [99] as well as the relationship between phenomenology of the clinical subtypes and course.…”

Section: Discussionmentioning

confidence: 99%

Management of Delirium in Palliative Care: a Review

Grassi

Caraceni

Mitchell

et al. 2015

Curr Psychiatry Rep

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Delirium is a complex but common disorder in palliative care with a prevalence between 13 and 88 % but a particular frequency at the end of life (terminal delirium). By reviewing the most relevant studies (MEDLINE, EMBASE, PsycLit, PsycInfo, Cochrane Library), a correct assessment to make the diagnosis (e.g., DSM-5, delirium assessment tools), the identification of the possible etiological factors, and the application of multicomponent and integrated interventions were reported as the correct steps to effectively manage delirium in palliative care. In terms of medications, both conventional (e.g., haloperidol) and atypical antipsychotics (e.g., olanzapine, risperidone, quetiapine, aripiprazole) were shown to be equally effective in the treatment of delirium. No recommendation was possible in palliative care regarding the use of other drugs (e.g., α-2 receptors agonists, psychostimulants, cholinesterase inhibitors, melatonergic drugs). Non-pharmacological interventions (e.g., behavioral and educational) were also shown to be important in the management of delirium. More research is necessary to clarify how to more thoroughly manage delirium in palliative care.

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Defining delirium for the International Classification of Diseases, 11th Revision

Cited by 49 publications

References 58 publications

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

Management of Delirium in Palliative Care: a Review

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