Phenomenology of delirium among patients admitted to a coronary care unit

Abstract

Aim: To study the phenomenology and motor sub-types of delirium in patients admitted in a Coronary Care Unit (CCU).

Methods: Three hundred and nine consecutive patients were screened for delirium, and those found positive for the same were evaluated by a psychiatrist on DSM-IVTR criteria to confirm the diagnosis. Those with a diagnosis of delirium were evaluated on the DRS-R-98 to study the phenomenology and on the amended Delirium Motor Symptom Scale (DMSS) to study the motor sub-types.

Results: Eighty-one patients were found to have delirium. Commonly seen symptoms of delirium included: disturbances in sleep–wake cycle, lability of affect, thought abnormality, disturbance in attention, disorientation, short-term memory, and long–term memory. Very few patients had delusions. More than half of the participants were categorized as having hyperactive (n = 46; 56.8%) followed by hypoactive sub-type (n = 21; 26%) and mixed sub-type (n = 9; 11.1%) of delirium. There were minor differences in the frequency and severity of symptoms of delirium between incidence and prevalence cases of delirium and those with different motoric sub-types.

Conclusion: Delirium in CCU set-up is characterized by the symptoms of disturbances in sleep–wake cycle, lability of affect, thought abnormality, disturbance in attention, disorientation, short-term memory, and long-term memory. Hyperactive delirium is more common than hypoactive delirium.

Keywords:

• Delirium
• cardiac illness
• intensive care unit

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.