Author, as appears in the article.: Sepulveda, Esteban; Franco, Jose G; Trzepacz, Paula T; Gaviria, Ana M; Vinuelas, Eva; Palma, Jose; Ferre, Gisela; Grau, Imma; Vilella, Elisabet
Department: Infermeria Medicina i Cirurgia
URV's Author/s: Ferré Rey, Gisela / FRANCO VÁSQUEZ, JOSÉ GABRIEL / GRAU JOAQUIN, INMACULADA CONCEPCIÓN / Sepulveda Ramos, Esteban / Vilella Cuadrada, Elisabet
Abstract: © 2015 The Academy of Psychosomatic Medicine. Background: Delirium diagnosis in elderly is often complicated by underlying dementia. Objective: We evaluated performance of the Delirium Rating Scale-Revised-98 (DRS-R98) in patients with high dementia prevalence and also assessed concordance among past and current diagnostic criteria for delirium. Methods: Cross-sectional analysis of newly admitted patients to a skilled nursing facility over 6 months, who were rated within 24-48 hours after admission. Interview for Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-R (DSM)-III-R, DSM-IV, DSM-5, and International Classification of Diseases 10th edition delirium ratings, administration of the DRS-R98, and assessment of dementia using the Informant Questionnaire on Cognitive Decline in the Elderly were independently performed by 3 researchers. Discriminant analyses (receiver operating characteristics curves) were used to study DRS-R98 accuracy against different diagnostic criteria. Hanley and McNeil test compared the area under the curve for DRS-R98's discriminant performance for all diagnostic criteria. Results: Dementia was present in 85/125 (68.0%) subjects, and 36/125 (28.8%) met criteria for delirium by at least 1 classification system, whereas only 19/36 (52.8%) did by all. DSM-III-R diagnosed the most as delirious (27.2%), followed by DSM-5 (24.8%), DSM-IV-TR (22.4%), and International Classification of Diseases 10th edition (16%). DRS-R98 had the highest AUC when discriminating DSM-III-R delirium (92.9%), followed by DSM-IV (92.4%), DSM-5 (91%), and International Classification of Diseases 10th edition (90.5%), without statistical differences among them. The best DRS-R98 cutoff score was ≥14.5 for all diagnostic systems except International Classification of Diseases 10th edition (≥15.5). Conclusions: There is a low concordance across diagnostic systems for identification of delirium. The DRS-R98 performs well despite differences across classification systems perhaps because it broadly assesses phenomenology, even in this population with a high prevalence of dementia.
Thematic Areas: Saúde coletiva Psychology Psychiatry and mental health Psychiatry Psicología Medicina ii Medicina i Interdisciplinar Ciencias sociales Ciencias humanas Arts and humanities (miscellaneous) Applied psychology
licence for use: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 15457206
Author's mail: esteban.sepulveda@urv.cat elisabet.vilella@urv.cat gisela.ferre@urv.cat gisela.ferre@urv.cat
Author identifier: 0000-0002-1887-5919
Record's date: 2024-10-12
Papper version: info:eu-repo/semantics/acceptedVersion
Link to the original source: https://www.sciencedirect.com/science/article/pii/S0033318215000584?via%3Dihub#!
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Psychosomatics. 56 (5): 530-541
APA: Sepulveda, Esteban; Franco, Jose G; Trzepacz, Paula T; Gaviria, Ana M; Vinuelas, Eva; Palma, Jose; Ferre, Gisela; Grau, Imma; Vilella, Elisabet (2015). Performance of the Delirium Rating Scale-Revised-98 Against Different Delirium Diagnostic Criteria in a Population With a High Prevalence of Dementia. Psychosomatics, 56(5), 530-541. DOI: 10.1016/j.psym.2015.03.005
Article's DOI: 10.1016/j.psym.2015.03.005
Entity: Universitat Rovira i Virgili
Journal publication year: 2015
Publication Type: Journal Publications