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Delirium in psychiatric inpatients: a case-control study.
S B Patten1, J V Williams, R Petcu
1Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta. patten@ucalgary.ca
Summary
Delirium in psychiatric inpatients is linked to older age, cognitive issues, and substance use. Minimizing anticholinergic and high-dose antipsychotic use may prevent delirium.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Epidemiology
Background:
- Delirium is a common and serious condition in psychiatric inpatients.
- Identifying risk factors and preventative strategies is crucial for this vulnerable population.
Purpose of the Study:
- To investigate clinical and pharmacoepidemiological factors associated with delirium in psychiatric inpatients.
- To identify potential targets for delirium prevention in this setting.
Main Methods:
- A case-control study design was employed.
- Subjects were identified using hospital discharge data and confirmed through clinical record review.
- Exposure data, including medication use, were collected from medical records.
Main Results:
- Older age, pre-existing cognitive deficits, and substance use disorders were associated with delirium.
- Lithium, anticholinergic antiparkinsonian medications, and standard or higher-dose antipsychotics were linked to delirium development.
- Antidepressant and sedative-hypnotic medications showed no association with delirium.
Conclusions:
- Conservative dosing of antipsychotics and reduced use of anticholinergics for parkinsonism may prevent delirium.
- Anticonvulsant mood stabilizers may pose a lower delirium risk compared to lithium.
- Antidepressants and sedative-hypnotics are not significant determinants of delirium in this population.