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    How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients.

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    Authors
    Glynn, Kevin
    McKenna, Frank
    Lally, Kevin
    O'Donnell, Muireann
    Grover, Sandeep
    Chakrabarti, Subho
    Avasthi, Ajit
    Mattoo, Surendra K
    Sharma, Akhilesh
    Gosh, Abhishek
    Shah, Ruchita
    Hickey, David
    Fitzgerald, James
    Davis, Brid
    O'Regan, Niamh
    Adamis, Dimitrious
    Williams, Olugbenja
    Awan, Fahad
    Dunne, C
    Cullen, Walter
    McInerney, Shane
    McFarland, John
    Jabbar, Faiza
    O'Connell, Henry
    Trzepacz, Paula T
    Leonard, Maeve
    Meagher, David
    Show allShow less
    Issue Date
    2021-04-14
    Keywords
    delirium & cognitive disorders
    dementia
    geriatric medicine
    PSYCHIATRY
    
    Metadata
    Show full item record
    Journal
    BMJ open
    URI
    http://hdl.handle.net/10147/631163
    DOI
    10.1136/bmjopen-2020-041214
    PubMed ID
    33853791
    Abstract
    Objectives: To investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology. Design: Cross-sectional study. Setting: International study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings. Participants: 1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV). Primary and secondary outcome measures: Hyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory. Results: Hypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001). Conclusions: This study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.
    Item Type
    Article
    Other
    Language
    en
    EISSN
    2044-6055
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2020-041214
    Scopus Count
    Collections
    University Hospitals Limerick

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