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Recognizing changes in cognition in sub types of acute confusional state
Raheel Mushtaq1, Sheikh Shoib1, Tabindah Shah2
1Senior Resident, Memory Clinic, Department of Psychiatry, Government Medical College , Srinagar, Kashmir, India .
Journal of Clinical and Diagnostic Research : JCDR
|September 2, 2014
Summary
Hypoactive delirium causes more cognitive impairment than hyperactive delirium, with significant day-to-night fluctuations in cognitive symptoms, especially in hypoactive cases.
Area of Science:
- Neuropsychiatry
- Cognitive Science
Background:
- Delirium, an acute confusional state, presents with diverse cognitive dysfunctions.
- Comprehensive studies on delirium in India are lacking.
Purpose of the Study:
- To assess and compare cognitive dysfunctions in hypoactive and hyperactive delirium.
- To investigate the diurnal variation of cognitive symptoms in delirium.
Main Methods:
- A study involving 40 delirium patients and 40 controls (neuropsychiatric patients).
- Cognitive assessment using the Cognitive Status Estimation Test, Mini-Mental State Examination (MMSE), and Memorial Delirium Assessment Scale.
- Assessments conducted thrice daily over 24 hours, with data analyzed using independent t-tests.
Main Results:
- Hypoactive delirium demonstrated more significant cognitive impairment than hyperactive delirium (p=0.001).
- A statistically significant diurnal variation (day to night) in MMSE scores was observed in both delirium subtypes (p=0.001).
Conclusions:
- Cognitive symptom intensity fluctuates between day and night in both delirium types, with greater variation in hypoactive delirium.
- Wider fluctuations in cognitive dysfunction were noted in delirium patients with psychosis.
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