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Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98)
Steven Thurber1, Yasuhiro Kishi, Paula T Trzepacz
1From the Child and Adolescent Behavioral Health Services, Minnesota Dept. of Human Services, Willmar, MN (ST); the Dept. of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kawasaki-City, Kanagawa, Japan (YK); Lilly Research Laboratories and the Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN (PTT); Hospital Psiquiatric Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Reus, Tarragona, Spain and, Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia (JGF); the Dept. of Psychiatry, University of Limerick School of Medicine, Limerick, Ireland, and School of Medicine, University College Dublin, Ireland (DJM, ML); the Dept. of Psychiatry, Mungyeong Jeil General Hospital, Mungyeong, South Korea (YL); the Dept. of Psychiatry, College of Medicine, Chungnam National University, Daejeon, South Korea (JLK); the Dept. of Internal Medicine, Federal University of Santa Catarina, Santa Catarina, Brazil (LMF, DN); the Dept. of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan (MCH); the Dept. of Psychiatry, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan (CHC); and the Dept. of Rehabilitation Medicine, Indiana University School of Medicine, Indianapolis, IN (JK).
Abstract:
Principal components analysis applied to the Delirium Rating Scale-Revised-98 contributes to understanding the delirium construct. Using a multisite pooled international delirium database, the authors applied confirmatory factor analysis to Delirium Rating Scale-Revised-98 scores from 859 adult patients evaluated by delirium experts (delirium, N=516; nondelirium, N=343). Confirmatory factor analysis found all diagnostic features and core symptoms (cognitive, language, thought process, sleep-wake cycle, motor retardation), except motor agitation, loaded onto factor 1. Motor agitation loaded onto factor 2 with noncore symptoms (delusions, affective lability, and perceptual disturbances). Factor 1 loading supports delirium as a single construct, but when accompanied by psychosis, motor agitation's role may not be solely as a circadian activity indicator.
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