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A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria

  • Dimitrios Adamis (a1) (a2), Siobhan Rooney (a3), David Meagher (a4), Owen Mulligan (a1) and Geraldine McCarthy (a3)...
Abstract
Background:

The recently published DSM-5 criteria for delirium may lead to different case identification and rates of delirium than previous classifications. The aims of this study are to determine how the new DSM-5 criteria compare with DSM-IV in identification of delirium in elderly medical inpatients and to investigate the agreement between different methods, using CAM, DRS-R98, DSM-IV, and DSM-5 criteria.

 Methods:

Prospective, observational study of elderly patients aged 70+ admitted under the acute medical teams in a regional general hospital. Each participant was assessed within 3 days of admission using the DSM-5, and DSM-IV criteria plus the DRS-R98, and CAM scales.

 Results:

We assessed 200 patients [mean age 81.1±6.5; 50% female; pre-existing cognitive impairment in 63%]. The prevalence rates of delirium for each diagnostic method were: 13.0% (n = 26) for DSM-5; 19.5% (n = 39) for DSM-IV; 13.5% (n = 27) for DRS-R98 and 17.0%, (n = 34) for CAM. Using tetrachoric correlation coefficients the agreement between DSM-5 and DSM-IV was statistically significant (ρtetr = 0.64, SE = 0.1, p < 0.0001). Similar significant agreement was found between the four methods.

 Conclusions:

DSM-IV is the most inclusive diagnostic method for delirium, while DSM-5 is the most restrictive. In addition, these classification systems identify different cases of delirium. This could have clinical, financial, and research implications. However, both classification systems have significant agreement in the identification of the same concept (delirium). Clarity of diagnosis is required for classification but also further research considering the relevance in predicting outcomes can allow for more detailed evaluation of the DSM-5 criteria.
Copyright
COPYRIGHT: © International Psychogeriatric Association 2015 
Corresponding author
Correspondence should be addressed to: Dimitrios Adamis, Consultant Psychiatrist, Sligo Mental Health Services Clarion Rd Sligo, Ireland. Phone: +353719144829; Fax: +353719144177. Email: dimaadamis@yahoo.com.
References
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Adamis, D., Treloar, A., Martin, F. C. and Macdonald, A. J. (2010). Ethical research in delirium: arguments for including decisionally incapacitated subjects. Science and Engineering Ethics, 16, 169–174.
Adamis, D., Treloar, A., Martin, F. C. and Macdonald, A. J. D. (2007). A brief review of the history of delirium as a mental disorder. History of Psychiatry, 18, 459–469.
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. DSM-III. Washington, DC: American Psychiatric Association.
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. Revised. DSM-IIIR. Washington, DC: American Psychiatric Association.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. DSM-IV. Washington, DC: American Psychiatric Association.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. DSM-5. Arlington, VA: American Psychiatric Association.
Aru, J. and Bachmann, T. (2013). Phenomenal awareness can emerge without attention. Frontier in Human Neuroscience, 7, 891.
Blazer, D. G. and van Nieuwenhuizen, A. O. (2012). Evidence for the diagnostic criteria of delirium: an update. Current Opinion in Psychiatry, 25, 239–243.
Block, N. (2011). Perceptual consciousness overflows cognitive access. Trends in Cognitive Sciences, 15, 567–575.
Breitbart, W. and Alici, Y. (2008). Agitation and delirium at the end of life: “We couldn't manage him.” JAMA, 300, 2898–2910, E2891.
Cole, M. G. (2013). Subsyndromal delirium in old age: conceptual and methodological issues. International Psychogeriatric, 25, 863–866.
Cole, M. G., Dendukuri, N., McCusker, J. and Han, L. (2003). An empirical study of different diagnostic criteria for delirium among elderly medical inpatients. The Journal of Neuropsychiatry & Clinical Neurosciences, 15, 200–207.
Ely, E. W. et al. (2004). Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA, 291, 1753–1762.
European Delirium Association and American Delirium Society (2014). The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Medicine, 12, 141.
Franco, J. G. et al. (2010). Relationship between cognitive status at admission and incident delirium in older medical inpatients. The Journal of Neuropsychiatry & Clinical Neuroscience, 22, 329–337.
Harwood, D. M., Hope, T. and Jacoby, R. (1997). Cognitive impairment in medical inpatients. I: Screening for dementia–is history better than mental state? Age Ageing, 26, 31–35.
Kazmierski, J. et al. (2008). Clinical utility and use of DSM-IV and ICD-10 criteria and the memorial delirium assessment scale in establishing a diagnosis of delirium after cardiac surgery. Psychosomatics, 49, 73–76.
Koch, C. and Tsuchiya, N. (2007). Attention and consciousness: two distinct brain processes. Trends in Cognitive Sciences, 11, 16–22.
Laurila, J. V., Pitkala, K. H., Strandberg, T. E. and Tilvis, R. S. (2003). The impact of different diagnostic criteria on prevalence rates for delirium. Dement Geriatr Cogn Disord, 16, 156–162.
Liptzin, B. et al. (1991). An empirical study of diagnostic criteria for delirium. The American Journal of Psychiatry, 148, 454–457.
Liptzin, B., Levkoff, S. E., Gottlieb, G. L. and Johnson, J. C. (1993). Delirium. The Journal of neuropsychiatry and clinical neurosciences, 5, 154–160.
Martinez-Velilla, N., Alonso-Bouzon, C., Cambra-Contin, K., Ibanez-Beroiz, B. and Alonso-Renedo, J. (2013). Outcomes in complex patients with delirium and subsyndromal delirium one year after hospital discharge. International Psychogeriatric, 25, 2087–2088.
Meagher, D. J., Leonard, M., Donnelly, S., Conroy, M., Adamis, D. and Trzepacz, P. T. (2011). A longitudinal study of motor subtypes in delirium: relationship with other phenomenology, etiology, medication exposure and prognosis. Journal of Psychosomatic Research, 71, 395–403.
Meagher, D. J., Maclullich, A. M. and Laurila, J. V. (2008). Defining delirium for the international classification of diseases, 11th Revision. Journal of Psychosomatic Research, 65, 207–214.
Meagher, D. et al. (2014). Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98. BMC Medicine 12, 164.
Morandi, A. et al. (2013). Consensus and variations in opinions on delirium care: a survey of European delirium specialists. International Psychogeriatric, 25, 2067–2075.
Sacks, O. W. (2012). Hallucinations. New York: Alfred A. Knopf.
Sweet, L. et al. (2014). Ethical challenges and solutions regarding delirium studies in palliative care. Journal of Pain and Symptom Management, 48, 259–271.
Thomas, C., Kreisel, S. H., Oster, P., Driessen, M., Arolt, V. and Inouye, S. K. (2012). Diagnosing delirium in older hospitalized adults with dementia: adapting the confusion assessment method to international classification of diseases, tenth revision, diagnostic criteria. Journal of the American Geriatrics Society, 60, 1471–1477.
Treloar, A. J. and Macdonald, A. J. (1997a). Outcome of delirium: part 1. Outcome of delirium diagnosed by DSM-III-R, ICD-10 and CAMDEX and derivation of the reversible cognitive dysfunction scale among acute geriatric inpatients. International Journal of Geriatric Psychiatry, 12, 609–613.
Treloar, A. J. and Macdonald, A. J. (1997b). Outcome of delirium: part 2. Clinical features of reversible cognitive dysfunction–are they the same as accepted definitions of delirium? International Journal of Geriatric Psychiatry, 12, 614–618.
Trzepacz, P. T., Mittal, D., Torres, R., Kanary, K., Norton, J. and Jimerson, N. (2001). Validation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium. The Journal of Neuropsychiatry and Clinical Neurosciences, 13, 229–242.
Van den Bussche, E., Hughes, G., Humbeeck, N. V. and Reynvoet, B. (2010). The relation between consciousness and attention: an empirical study using the priming paradigm. Consciousness and Cognition, 19, 86–97.
Witlox, J., Eurelings, L. S., de Jonghe, J. F., Kalisvaart, K. J., Eikelenboom, P. and van Gool, W. A. (2010). Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA, 304, 443–451.
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International Psychogeriatrics
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  • EISSN: 1741-203X
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