Assessing Delirium Vulnerability in Patients Referred to Consultation-Liaison Psychiatry Service: A Cross-Sectional...

A large proportion of patients suffering from medical conditions also experience mental health problems, cooperation of both side's professionals, seems to ensure the best way to reduce the existing gap and to create the best diagnostic-treatment plan, Consultation-Liaison Psychiatry provides this possibility in a general hospital. Delirium is one of the most important consultations requested by medical professionals for psychiatric services because it is a condition that threatens life and worsens the prognosis of patients. In this study, we conducted a comprehensive investigation of delirium and its related factors among patients in general hospitals.

This cross-sectional analytical study was conducted in medical wards of a General Educational hospital in North Iran in 2022, Sampling was done among 864 patients, hospitalized in different medical departments who were requested by their medical specialists for consultation by the psychiatric service, The information collected for this study was obtained based on the recorded data in the psychiatric consultation sheets, All psychiatric diagnoses in this project were based on DSM-5 diagnostic criteria.

Our analysis revealed a significant increase in the incidence of delirium among patients with advancing age (p < 0.001), those with an educational level below diploma (p < 0.001), and individuals who are widowed (p < 0.001). Additionally, abnormalities in all laboratory tests were significantly correlated with a higher rate of delirium (p < 0.001), with the exception of thyroid dysfunction tests and positive urine toxicology results. Regarding disease classification, delirium was most frequently observed in patients with multiple comorbidities, accounting for 55%, followed by those with lung disease at 49.5%. In all types of medical diseases, the incidence of hyperactive and mixed-state delirium was significantly higher (p-value = 0.009). Additionally, we observed that the majority of patients with delirium had no history of active substance use (81%) or underlying dementia (92.4%).

The results of our study demonstrate that advanced age, lower educational attainment, widowhood, and the presence of multiple comorbidities are significant risk factors for delirium among hospitalized patients. Furthermore, disturbances in laboratory parameters-excluding thyroid dysfunction and positive urine toxicology-are strongly associated with increased delirium risk. Notably, the majority of patients experiencing delirium had no prior history of active substance use or underlying dementia, as evidenced by our findings.