International Psychogeriatrics

Delirium: Advances in Research and Clinical Practice
Diagnostic Criteria and Assessment Instruments

Delirium in the Medically Ill Elderly: Operationalizing the DSM-III Criteria

Gary L. Gottlieb a1, Jerry Johnson a2, Christine Wanich a3 and Eileen Sullivan a3
a1 Department of Psychiatry, Hospital of the University of Pennsylvania, U.S.A.
a2 Department of Medicine, Hospital of the University of Pennsylvania, U.S.A.
a3 School of Nursing, University of Pennsylvania and Ralston–Penn Center, Philadelphia, Pennsylvania, U.S.A.

Article author query
gottlieb g   [PubMed][Google Scholar] 
johnson j   [PubMed][Google Scholar] 
wanich c   [PubMed][Google Scholar] 
sullivan e   [PubMed][Google Scholar] 


This prospective study determined the incidence and prevalence of delirium in 235 consecutive subjects over age 70 admitted to a general medicine hospital service. The DSM-III criteria for delirium were operationalized. Using accepted screening procedures, patients were referred for evaluation by a psychiatrist who determined whether delirium was present by applying explicit operational definitions to each of the DSM-III criteria. Data on presence and severity of each of the DSM-III symptoms were recorded. Analysis of these data indicates that the DSM-III criteria describe a discrete, recognizable syndrome. However, some of the symptoms are more specific than others in identifying the syndrome in this population.