Etiologic and outcome profiles in hypoactive and hyperactive subtypes of delirium

The existence of hyperactive, hypoactive, or mixed clinical subtypes of delirium is widely accepted. But relationships between these motor profiles and etiology or outcome remain unclear. The aim of this study was to compare etiologic and outcome profiles in a case series of 183 elderly patients (mean age = 84.1 years, SD = 5.9) consecutively admitted into the geriatric wards of two French university hospitals or referred to a geriatric psychiatry consultation-liaison unit within a Swiss university hospital. All patients met DSM-III-R criteria for delirium and were classified into clinical subtypes according to the results of a previous factor analysis of scores on a 19-item checklist rating a wide range of delirium symptoms. The hyperactive subtype was more frequent (n = 85, 46.5%) than the unspecified (n = 50, 27.3%) and hypoactive subtypes (n = 48, 26.2%). There was no significant difference in terms of etiologic or outcome profile between clinical subtype groups. The presence of acute metabolic disorders, cardiovascular disease, and hyperthermia as etiologic factors was significantly associated with full recovery of the episode at 3 weeks follow-up, whereas probable preexisting dementia was significantly associated with partial recovery or failure to recover.