Delirium subtype identification and the validation of the Delirium Rating Scale - Revised-98 (Dutch version) in hospitalized elderly patients
Delirium subtype identification and the validation of the Delirium Rating Scale - Revised-98 (Dutch version) in hospitalized elderly patients
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DOI：
10.1002/gps.1577
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发表时间：
2006-09-01
影响因子：
4
通讯作者：
Levi, Marcel
中科院分区：
文献类型：
--
作者：
de Rooij, Sophia E.;van Munster, Barbara C.;Levi, Marcel
背景谵妄是住院老年人最常见的急性神经精神障碍。荷兰版谵妄评定量表-修订-98 （DRS-R-98）似乎是一种可靠的方法来分类谵妄。本研究的目的是确定DRS-R-98的有效性和可靠性，并使用drs -98研究谵妄的临床亚型。方法采用荷兰版DRS-R-98、简易精神状态检查、神志不清评定法，根据DSM-IV标准进行谵妄临床诊断，家属采用老年人认知能力下降问卷。结果DRS-R-98验证队列（n = 65）包括23例谵妄患者，22例痴呆患者和20例非精神病学对照患者。对于谵妄亚型研究，第二队列包括54名谵妄患者进行了调查。中位DRS-R-98评分显著区分谵妄与痴呆，无精神障碍。评等间信度（类内相关0.97）和内部一致性（Crohnbach’s alpha 0.94）较高。DRS-R-98第4项（情感责任）和第7项（运动性躁动）的阳性评分预测非低活动性谵妄的存在，特异性为89%，敏感性为57%。结论荷兰版DRS-R-98是一种有效、可靠的谵妄严重程度的测量方法，可将谵妄患者与痴呆患者及对照患者区分出来。此外，DRS-R-98还能排除低活动性谵妄。版权所有(c) 2006约翰威利父子有限公司
Background Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale-Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the DRS-R-98 and to study clinical subtypes of delirium using the DRSR-98.Methods Patients received the Dutch version of the DRS-R-98, the Mini-Mental State Examination, the Confusion Assessment Method, and a clinical diagnosis of delirium according to DSM-IV criteria, and their relatives the Informant Questionnaire Cognitive Decline in the Elderly.Results The DRS-R-98 validation cohort (n = 65) consisted of 23 patients with delirium, 22 patients with dementia, and 20 non-psychiatric comparison patients. For the delirium subtype study, a second cohort comprising 54 delirious patients was investigated. Median DRS-R-98 scores significantly distinguished delirium from dementia and no psychiatric disorder. Inter-rater reliability (intra-class correlation 0.97) and internal consistency (Crohnbach's alpha 0.94) were high. Positive scores of DRS-R-98 item 4 (affect liability) and item 7 (motor agitation) predicted the presence of non-hypoactive delirium, with a specificity of 89% and a sensitivity of 57%.Conclusion The results show that the Dutch version of the DRS-R-98 is a valid and reliable measure of delirium severity and distinguishes patients with delirium from patients with dementia and comparison patients. Furthermore, the DRS-R-98 is able to exclude hypoactive delirium. Copyright (c) 2006 John Wiley & Sons, Ltd.