Phenomenology and diagnostic criteria for delirium and subsyndromal delirium in a population with high prevalence of dementia. An empirical study

Identifier:  TDX:2469

Handle: https://hdl.handle.net/20.500.11797/TDX2469

Authors:  Sepúlveda Ramos, Esteban

Abstract:
The validity and reliability of modern diagnostic classifications for delirium have been challenged to varying degrees. In this paper we demonstrate the low diagnostic coincidence of DSM-III-R, DSM-IV, DSM-5 and ICD-10. The inter-rater reliability improves in the newer DSM editions, but its validity worsens and ICD-10 generally has worse results. The DRS-R98 scale assesses broadly and with a clear phenomenological description delirium symptoms. We confirmed the validity of its Spanish version in a population with a high prevalence of dementia, regardless of the criteria used for diagnosis. Finally, we evaluated a new diagnostic proposal for subsyndromal delirium and found it presents symptoms with intermediate severity between delirium and controls as well as a similar phenomenological profile regardless of the clinical setting. Clearer diagnostic criteria for delirium, based on its core symptoms, and possibly supported by a biomarker are necessary to improve their validity.