title: Recognizing changes in cognition in sub types of acute confusional state.
abstract: BACKGROUND
  Delirium or acute confusional state is an acute neuropsychiatric syndrome, with varied cognitive dysfunctions. However, no comprehensive studies about this common condition have been carried out in India.
  
  
  OBJECTIVE
  To assess cognitive dysfunctions in hypoactive and hyperactive delirium.
  
  
  METHODS
  Forty cases of delirium including hypoactive and hyperactive delirium and 40 other patients (neuropsychiatric patients) were studied as controls. Cognitive status estimation test, mini mental state examination and memorial delirium assessment scale were administered to each patient. All assessments were carried out three times in 24 hour cycle of day and night. The data was analysed using two sample independent t-test.
  
  
  RESULTS
  The mean age (standard deviation) of study and control group was 27.85 (13.73) and 33.10 (11.26) years respectively. 70% patients had hyperactive delirium while 30% were having hypoactive delirium. Hypoactive delirium had more cognitive impairment compared to hyperactive delirium (p=0.001). The difference between highest and lowest score of MMSE in both types of delirium (day to night) was found to be statically significant (p=0.001).
  
  
  CONCLUSIONS
  The fluctuation in intensity of cognitive symptoms varies from day to night in both types of delirium, but more in hypoactive delirium and wider fluctuation in cognitive dysfunctions was noted in delirium cases with psychosis.
authors.affiliation: Senior Resident, Memory Clinic, Department of Psychiatry, Government Medical College , Srinagar, Kashmir, India .
authors.forename: Raheel
authors.initials: R
authors.lastname: Mushtaq
authors.affiliation: Senior Resident, Memory Clinic, Department of Psychiatry, Government Medical College , Srinagar, Kashmir, India .
authors.forename: Sheikh
authors.initials: S
authors.lastname: Shoib
authors.affiliation: Intern, Department of Psychiatry, Government Medical College , Srinagar, Kashmir, India .
authors.forename: Tabindah
authors.initials: T
authors.lastname: Shah
authors.affiliation: Head of Department, Memory Clinic, Department of Psychiatry, Government Medical College , Srinagar, Kashmir, India .
authors.forename: M Maqbool
authors.initials: MM
authors.lastname: Dar
authors.affiliation: MBBS Student, ASCOMS , Jammu, India .
authors.forename: Sahil
authors.initials: S
authors.lastname: Mushtaq
keywords: MMSE; Neuropsychiatric syndrome; Psychosis