Features of subsyndromal and persistent delirium

Area of Science:

• Geriatric Medicine
• Neuroscience
• Psychiatry

Background:

• Longitudinal studies on delirium phenomenology are scarce.
• Understanding delirium subtypes and their progression is crucial for effective clinical management.
• This study addresses the gap in longitudinal data on delirium features.

Purpose of the Study:

• To characterize subsyndromal delirium and persistent delirium over time.
• To identify distinguishing features between full syndromal and subsyndromal delirium.
• To analyze symptom patterns in resolving versus persistent delirium.

Main Methods:

• 100 adult patients with DSM-IV delirium were evaluated twice weekly.
• The Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD) were used for assessments.
• Generalized estimating equation models identified symptom patterns.

Main Results:

• Full syndromal delirium exhibited significantly greater severity in cognitive and non-cognitive symptoms compared to subsyndromal delirium.
• Persistent full syndromal delirium showed more pronounced disturbances in thought processes, delusions, agitation, orientation, attention, and memory.
• Specific DRS-R98 and CTD items differentiated the severity and persistence of delirium symptoms.

Conclusions:

• Full syndromal delirium is distinguished from subsyndromal delirium by the greater severity of numerous cognitive and non-cognitive symptoms.
• Persistent delirium is characterized by the increasing prominence of core diagnostic features and cognitive impairment.
• These findings enhance understanding of delirium's temporal evolution and symptom profiles.