• Sandeep Grover, Natasha Kate, Munish Agarwal, Surendra Kumar Mattoo, Ajit Avasthi, Savita Malhotra, Parmanand Kulhara, Subho Chakrabarti, and Debasish Basu.
• Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsandeepg2002@yahoo.com
• Int Psychogeriatr. 2012 Jan 1; 24 (1): 117-27.

BackgroundVery few studies from India have studied the phenomenology of delirium. The aim of the present study was to study the phenomenology as measured using the Delirium Rating Scale-Revised-98 (DRS-R98), the associated etiologies and the outcome of delirium among the elderly participants seen by the consultation-liaison psychiatric service in India. In addition, an attempt was made to study the factor structure of symptoms using principal components analysis.MethodsThe case notes of 109 elderly patients referred to psychiatry liaison services were reviewed.ResultsThe mean age of the sample was 73.35 years (SD: 7.44; range 65-95 years) and two-thirds of the sample had hospital emergent delirium. The mean DRS-R98 severity score was 18.77 and the DRS-R98 total score was 24.81. In 15 patients the DRS-R98 scores were in the subsyndromal range. Among the various symptoms present, most patients had sleep-wake cycle disturbance, disturbance in orientation, attention and short-term memory impairments, fluctuation of symptoms, temporal onset of symptoms and a physical disorder. Principal components analysis identified three factors which explained 43.5% of variance of symptomatology and it yielded a three-factor structure. Endocrine/metabolic disturbances were the commonest associated etiological category with delirium. The mean hospital stay after being referred to psychiatry referral services was 8.89 days, after which delirium improved in 58.7% of cases. The mortality rate during the inpatient stay was 16.5%.ConclusionsResults suggest that the symptoms of delirium as assessed by DRS-R98 separate out into a three-factor structure. Delirium is commonly associated with metabolic endocrine disturbances and about one-sixth of the patients die during the short inpatient stay.

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