Factor analysis supports the evidence of existing hyperactive and hypoactive subtypes of delirium

Abstract

Objective. The aim of this study was to examine whether delirium has speci®c clinical subtypes. Method. One hundred and eighty-three elderly subjects meeting DSM-IIIR criteria for delirium were evaluated using a 19-item symptom check-list assessing dierent dimensions of delirium symptomatology. Exploratory factor analysis was conducted in order to examine which symptoms clustered.Results. Factor analysis con®rmed the existence of two dierent clusters of symptoms: ®rst, symptoms of hyperalert/hyperactive features (agitation, hyper-reactivity, aggressiveness, hallucinations, delusions); and second, symptoms of hypoalert/hypoactive features (decreased reactivity, motor and speech retardation, facial inexpressiveness).Conclusion. This preliminary study seems to support the evidence of hypoactive and hyperactive subtypes of delirium, even though their aetiology and prognostic values need to be further examined.

Safety and Efficacy of Flumazenil for Reversal of Iatrogenic Benzodiazepine-Associated Delirium Toxicity During Treatment of Alcohol Withdrawal, a Retrospective Review at One Center

“…Documentation from the physician care team was also used to confirm diagnoses of delirium and assign phenomenological subtypes (i.e., hypoactive, hyperactive, or mixed) [21][22][23] based on the Riker scale [24,25] or patient description if the Riker scale was not found. Delirium was diagnosed by the DSM-IV-TR criteria.…”

A factor analytic study of the Delirium Rating Scale-Revised-98 in untreated patients with delirium

“…A number of such factor analytic studies have been undertaken to study the phenomenology of delirium [8][9][10][11][12][13][14][15][16][17][18], but they have usually included particular groups of patients such as the elderly [8][9][10][11] or critically ill patients [12,13], or those with specific diagnoses like malignancies [14][15][16].…”

Assessment of Medical/Surgical Patients

“…Delirium may be of the hyperactive type associated with agitation, aggressive behavior, hallucinations, and delusions; or the hypoactive type, with decreased reactivity, motor and speech retardation, and facial inexpressiveness. 8 The latter is commonly mistaken for depression in medical settings.…”