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 a3andEileen 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.
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.