title: Features of subsyndromal and persistent delirium.
abstract: BACKGROUND
  Longitudinal studies of delirium phenomenology are lacking.
  
  
  OBJECTIVE
  We studied features that characterise subsyndromal delirium and persistent delirium over time.
  
  
  METHODS
  Twice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale-Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium.
  
  
  RESULTS
  Participants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2-9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation.
  
  
  CONCLUSIONS
  Full syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
authors.affiliation: Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland. david.meagher@ul.ie
authors.forename: David
authors.initials: D
authors.lastname: Meagher
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Adamis
authors.forename: Paula
authors.initials: P
authors.lastname: Trzepacz
authors.forename: Maeve
authors.initials: M
authors.lastname: Leonard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001569:Benzodiazepines / Q000627:therapeutic use; D015897:Comorbidity; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D003704:Dementia / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009483:Neuropsychological Tests; D010166:Palliative Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D013577:Syndrome
chemical_list: D001569:Benzodiazepines