• J Psychosom Res · Sep 2008

    Review

    Delirium phenomenology: what can we learn from the symptoms of delirium?

    • Nitin Gupta, Jos de Jonghe, Jan Schieveld, Maeve Leonard, and David Meagher.
    • South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Burton on Trent, United Kingdom. nitingupta659@yahoo.co.in
    • J Psychosom Res. 2008 Sep 1; 65 (3): 215-22.

    ObjectivesThis review focuses on phenomenological studies of delirium, including subsyndromal and prodromal concepts, and their relevance to other elements of clinical profile.MethodsA Medline search using the keywords delirium, phenomenology, and symptoms for new data articles published in English between 1998 and 2008 was utilized. The search was supplemented by additional material not identified by Medline but known to the authors.ResultsUnderstanding of prodromal and subsyndromal concepts is still in its infancy. The characteristic profile can differentiate delirium from other neuropsychiatric disorders. Clinical (motoric) subtyping holds potential but more consistent methods are needed. Studies are almost entirely cross-sectional in design and generally lack comprehensive symptom assessment. Multiple assessment tools are available but are oriented towards hyperactive features and few have demonstrated ability to distinguish delirium from dementia. There is insufficient evidence linking specific phenomenology with etiology, pathophysiology, management, course, and outcome.ConclusionsDespite the major advancements of the past decade in many aspects of delirium research, further phenomenological work is crucial to targeting studies of causation, pathophysiology, treatment, and prognosis. We identified eight key areas for future studies.

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