%0 Journal Article
%T The Phenomenology of Delirium: Presence, Severity, and Relationship between Symptoms
%A Soenke Boettger
%A Susanne Boettger
%A William Breitbart
%J Journal of Geriatrics
%D 2014
%R 10.1155/2014/427042
%X Objective. To examine the phenomenological characteristics of delirium based on the Memorial Delirium Assessment Scale (MDAS) in order to explore the presence, severity of, and relationship between symptoms. Methods. An analysis of 100 cases of delirium recruited at Memorial Sloan Kettering Cancer Center (MSKCC) was performed. Sociodemographic and medical variables, the Memorial Delirium Assessment Scale (MDAS) subitems, and Karnofsky Performance Status scale (KPS) were analyzed of respect of the phenomenological characteristics and their interrelationship. Results. The most severe and frequent symptoms were recorded in the cognitive domain, psychomotor behavior, sleep-wake cycle, and disturbance of consciousness. Within the cognitive domain, concentration was the most severely affected task. The severity of impairment in most domains increased with delirium severity, whereas perceptual disturbances and delusions were independent of delirium severity. Advanced age and the prevalence of dementia increased with delirium severity in contrast to the functional status which declined. The presence of perceptual disturbances and delusions was independent of cognitive impairment and psychomotor abnormality, however, associated with the disturbances of consciousness and attention. Conclusion. Cognition, in particular concentration, was the most severely affected domain. Advanced age and the prevalence of dementia contributed to more severe delirium. Perceptual disturbances and delusions were independent of delirium severity; however, they were associated with disturbances of consciousness and attention. 1. Introduction Delirium is a neuropsychiatric disorder which is characterized by disturbances of consciousness, attention, cognition, and perception with an abrupt onset and fluctuating course and an underlying physiological etiology [1]. Further frequent symptoms of delirium include various mood changes, sleep-wake cycle disturbances, and psychomotor as well as language abnormalities [2]. The phenomenology of delirium has been examined in a number of studies. In a review [3], impairments in arousal have been recorded in 75% (48每82%), orientation in 76% (62每100%), attention in 65% (17每100%), memory in 84% (64每100%), thought process in 48% (2每68%), perception in 33% (20每78%), delusions in 27% (19每68%), psychomotor retardation in 59% (53每60%), psychomotor agitation in 44% (28每90%), and sleep-wake cycle in 53% (18每98%). The prevalence of perceptual disturbances and delusions was evaluated in further studies. Two studies revealed an approximately equal prevalence of
%U http://www.hindawi.com/journals/jger/2014/427042/