Delirium Research in India: A Systematic Review

Abstract

Delirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were “delirium,” “delirious,” “delirium tremens” AND “India.” No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms “delirium,” “delirious,” “delirium tremens” in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles (n = 81), and these were followed by, case reports (n = 58), review articles (n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials (n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context.

Relationship of Postoperative Serum Neuro-Specific Enolase Levels with Postoperative Delirium Occurring after Microvascular Depression Surgery in Older Patients

“…Delirium is an acute medical emergency, with psychiatric manifestations, which is seen across different treatment settings [39]. In our study, delirium was found to occur in 22.01% of postoperative MVD patients.…”

Delirium, polypharmacy and adverse outcomes: findings from a hospital in Kerala, India

“…Overall, our findings are comparable to studies conducted across different hospitals in India. [10][11][12]15 Similar studies in Kerala, South India, showed a lower prevalence of 16% in medical and surgical units 16 and 22% in intensive care units. 17 Another study further south reported an even lower prevalence of 10%.…”

“…Current data suggest delirium prevalence in hospitalised older people may vary from 5% to 44%. [10][11][12] This study aimed to estimate delirium prevalence and risk factors among hospitalised older people admitted in the medical and surgical wards of a teaching hospital in Central South India.…”

Low Dose Risperidone Prophylaxis for The Prevention of Delirium in The Intensive Care Unit: A Randomized, Placebo Controlled Trial

“…A review of delirium in India showed that the prevalence of ICU delirium is between 16.1 and 68.2%. 12 The majority of studies reported a hypoactive or a mixed delirium as the most common subtypes. 12 Multiple scales including the ICDSC, MAS and CAM-ICU have been validated in Indian ICUs for the diagnosis of delirium.…”

“…12 The majority of studies reported a hypoactive or a mixed delirium as the most common subtypes. 12 Multiple scales including the ICDSC, MAS and CAM-ICU have been validated in Indian ICUs for the diagnosis of delirium. 12 Patients with delirium were found to have longer ICU stays and a higher mortality rate.…”