title: Comparative Study of Delirium in Emergency and Consultation Liaison- A Tertiary Care Hospital Based Study in Northern India.
abstract: BACKGROUND
  Delirium is an acute and often fluctuating disturbance in level of consciousness and thought process (cognition) that develops over a short period of time and is a significant change from previous level of functioning. Its prevalence increases with age, complexity of medical co- morbidities and number of medications prescribed.
  
  
  OBJECTIVE
  To compare the cause and severity of delirium in patients in emergency and consultation liaison psychiatry group.
  
  
  METHODS
  A cross-sectional, tertiary care hospital based study was conducted on the patients who presented with delirium from emergency department (50) and consultation-liaison psychiatry groups (50), over a period of one year. The diagnosis was made on the basis of DSM- 5 criteria. The Delirium Rating Scale (DRS-R-98) was applied to know the severity of delirium, cognitive and non-cognitive symptoms of delirium in patients. The results were subjected to appropriate statistical analysis.
  
  
  RESULTS
  In emergency group, 42% patients had metabolic abnormalities, while in consultation-liaison, 38% patients had hyponatremia and hypokalemia and the difference was found to be statistically non-significant (p>0.05). In emergency group, 21(42%) patients were diagnosed as delirium due to other medical condition, followed by 13 (26%) and 8(16%) patients, who were diagnosed as delirium due to multiple aetiologies and substance intoxication each respectively. In only 33(66%) cases in consultation liaison group patients had delirium secondary to other medical conditions. As per DRS-R98 Scale, mean severity score was found to be statistically significant (p<0.05) in consultation liaison group as compared to emergency department group (p> 0.05).
  
  
  CONCLUSIONS
  Delirium is multifactorial aetiological disease, with variable but preventable outcome. Approach should be aimed at finding the treatable causes to reduce morbidity and mortality.
authors.affiliation: Student, Department of Psychiatry, Guru Gobind Singh Medical College and Hospital , Faridkot, Punjab, India .
authors.lastname: Prinka
authors.affiliation: Professor and Head, Department of Psychiatry, Guru Gobind Singh Medical College and Hospital , Faridkot, Punjab, India .
authors.forename: Arvind
authors.initials: A
authors.lastname: Sharma
keywords: Acute confusional state; Cognition; Consciousness