The predictive value of dysgraphia and constructional apraxia for delirium in psychiatric inpatients.
OBJECTIVE
To evaluate the predictive value of dysgraphia and constructional apraxia for delirium among psychiatric inpatients.


METHODS
Data were collected from 2 sources. First, a series of nondelirious psychiatric inpatients that had participated in a previous study was selected to determine the specificity of various indices of dysgraphia and constructional apraxia. Second, a series of 56 psychiatric inpatients with delirium as identified using electronic administrative data and clinical records was selected to evaluate sensitivity.


RESULTS
Of the various indices of dysgraphia examined, only a global rating of writing quality and evidence of jagged or angled letter loops were informative clinical signs. The predictive value of constructional apraxia resembled the predictive value of the 2 dysgraphia indices.


CONCLUSIONS
Dysgraphia and constructional apraxia are useful clinical signs of delirium in the psychiatric inpatient population. Evaluation of these functions can substantially impact diagnostic decisions where diagnostic uncertainty exists. An evaluation of writing and constructional praxis can be easily incorporated into bedside mental status examinations.
Baranowski
S L
SL
University of Calgary, Alberta.
Patten
S B
SB
D000328:Adult; D000368:Aged; D000381:Agraphia / Q000175:diagnosis* / Q000209:etiology*; D001072:Apraxias / Q000175:diagnosis* / Q000209:etiology*; D003693:Delirium / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests