dc.contributor.author | Meagher, David J | |
dc.contributor.author | Morandi, Alessandro | |
dc.contributor.author | Inouye, Sharon K | |
dc.contributor.author | Ely, Wes | |
dc.contributor.author | Adamis, Dimitrios | |
dc.contributor.author | Maclullich, Alasdair J | |
dc.contributor.author | Rudolph, James L | |
dc.contributor.author | Neufeld, Karin | |
dc.contributor.author | Leonard, Maeve | |
dc.contributor.author | Bellelli, Giuseppe | |
dc.contributor.author | Davis, Daniel | |
dc.contributor.author | Teodorczuk, Andrew | |
dc.contributor.author | Kreisel, Stefan | |
dc.contributor.author | Thomas, Christine | |
dc.contributor.author | Hasemann, Wolfgang | |
dc.contributor.author | Timmons, Suzanne | |
dc.contributor.author | O'Regan, Niamh | |
dc.contributor.author | Grover, Sandeep | |
dc.contributor.author | Jabbar, Faiza | |
dc.contributor.author | Cullen, Walter | |
dc.contributor.author | Dunne, Colum | |
dc.contributor.author | Kamholz, Barbara | |
dc.contributor.author | Van Munster, Barbara C | |
dc.contributor.author | De Rooij, Sophia E | |
dc.contributor.author | De Jonghe, Jos | |
dc.contributor.author | Trzepacz, Paula T | |
dc.date.accessioned | 2018-03-19T01:31:08Z | |
dc.date.available | 2018-03-19T01:31:08Z | |
dc.date.issued | 2014 | |
dc.identifier.issn | 1741-7015 | |
dc.identifier.doi | 10.1186/s12916-014-0164-8 | |
dc.identifier.uri | http://hdl.handle.net/10072/173829 | |
dc.description.abstract | Background: The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium
diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical
Manual fourth edition (DSM-IV) in a large dataset of patients assessed for delirium and related presentations.
Methods: Patient data (n = 768) from six prospectively collected cohorts, clinically assessed using DSM-IV and the
Delirium Rating Scale-Revised-98 (DRS-R98), were pooled. Post hoc application of DRS-R98 item scores were used to
rate DSM-5 criteria. ‘Strict’ and ‘relaxed’ DSM-5 criteria to ascertain delirium were compared to rates determined by
DSM-IV.
Results: Using DSM-IV by clinical assessment, delirium was found in 510/768 patients (66%). Strict DSM-5 criteria
categorized 158 as delirious including 155 (30%) with DSM-IV delirium, whereas relaxed DSM-5 criteria identified
466 as delirious, including 455 (89%) diagnosed by DSM-IV (P <0.001). The concordance between the different
diagnostic methods was: 53% (ĸ = 0.22) between DSM-IV and the strict DSM-5, 91% (ĸ = 0.82) between the DSM-IV
and relaxed DSM-5 criteria and 60% (ĸ = 0.29) between the strict versus relaxed DSM-5 criteria. Only 155 cases were
identified as delirium by all three approaches. The 55 (11%) patients with DSM-IV delirium who were not rated as
delirious by relaxed criteria had lower mean DRS-R98 total scores than those rated as delirious (13.7 ± 3.9 versus
23.7 ± 6.0; P <0.001). Conversely, mean DRS-R98 score (21.1 ± 6.4) for the 70% not rated as delirious by strict DSM-5
criteria was consistent with suggested cutoff scores for full syndromal delirium. Only 11 cases met DSM-5 criteria
that were not deemed to have DSM-IV delirium.
Conclusions: The concordance between DSM-IV and the new DSM-5 delirium criteria varies considerably
depending on the interpretation of criteria. Overly-strict adherence for some new text details in DSM-5 criteria
would reduce the number of delirium cases diagnosed; however, a more ‘relaxed’ approach renders DSM-5 criteria
comparable to DSM-IV with minimal impact on their actual application and is thus recommended. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | BioMed Central | |
dc.relation.ispartofpagefrom | 164-1 | |
dc.relation.ispartofpageto | 164-10 | |
dc.relation.ispartofissue | 1 | |
dc.relation.ispartofjournal | BMC Medicine | |
dc.relation.ispartofvolume | 12 | |
dc.subject.fieldofresearch | Biomedical and clinical sciences | |
dc.subject.fieldofresearch | Clinical sciences not elsewhere classified | |
dc.subject.fieldofresearchcode | 32 | |
dc.subject.fieldofresearchcode | 320299 | |
dc.title | Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98 | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
dcterms.license | http://creativecommons.org/licenses/by/4.0 | |
dc.description.version | Version of Record (VoR) | |
gro.rights.copyright | © 2014 Meagher et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated. | |
gro.hasfulltext | Full Text | |
gro.griffith.author | Teodorczuk, Andrew | |