Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T06:06:25.506Z Has data issue: false hasContentIssue false

Delirium classification by the diagnostic and statistical manual – a moving target

Published online by Cambridge University Press:  29 April 2015

Karin J. Neufeld*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, USA Email: kneufel2@jhmi.edu
Get access

Extract

The following paper, entitled “A Comparison of Delirium Diagnosis in Elderly Medical Inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 Criteria” by Adamis and colleagues, reports the results of a single delirium assessment of 200 medical inpatients, aged 70 years and older. The aim was to compare the prevalence of delirium using two different diagnostic classification systems (DSM-5 and DSM-IV) and two commonly used research tools (Confusion Assessment Method and the Delirium Rating Scale-Revised ‘98). This editorial focuses on the comparison of the two versions of the DSM. The authors conclude that, while both diagnostic systems identify a core concept of delirium, the DSM-IV criteria are the most inclusive of the four approaches and the DSM-5, the most restrictive, identifying a prevalence of 19.5% and 13%, respectively in this sample. Furthermore, they conclude that these two systems do not appear to detect the same patients: only 14 of 26 (54%) individuals identified as delirious by the more exclusive DSM-5 criteria were also identified as such by DSM-IV.

Type
Commentary paper of the month
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blazer, D. G. and van Nieuwenhuizen, A. O. (2012). Evidence for the diagnostic criteria of delirium: an update. Current Opinion in Psychiatry, 25, 239243. doi:10.1097/YCO.0b013e3283523ce8.Google Scholar
Cole, M. G. et al. (2013). The course of subsyndromal delirium in older long-term care residents. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 21, 289296. doi:10.1016/j.jagp.2012.12.008.Google Scholar
European Delirium Association and American Delirium Society (2014). The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Medicine, 12, 141. doi:10.1186/s12916-014-0141-2.Google Scholar
Gottlieb, G. L., Johnson, J., Wanich, C. and Sullivan, E. (1991). Delirium in the medically ill elderly: operationalizing the DSM-III criteria. International Psychogeriatrics/IPA, 3, 181196.Google Scholar
Lipowski, Z. J. (1990). Delirium: Acute Confusional States. New York: Oxford University Press.Google Scholar
Meagher, D., Adamis, D., Trzepacz, P. and Leonard, M. (2012). Features of subsyndromal and persistent delirium. The British Journal of Psychiatry: The Journal of Mental Science, 200, 3744. doi:10.1192/bjp.bp.111.095273; 10.1192/bjp.bp.111.095273.Google Scholar
Meagher, D. J. et al. (2014). Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98. BMC Medicine, 12, 164. doi:10.1186/s12916-014-0164-8.Google Scholar
Neufeld, K. J. et al. (2014). Delirium diagnosis methodology used in research: a survey-based study. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 22, 15131521. doi:10.1016/j.jagp.2014.03.003.Google Scholar