The Delirium Symptom Interview: An Interview for the Detection of Delirium Symptoms in Hospitalized Patients

Abstract

To study delirium in hospitalized elderly, a delirium symptom interview (DSI) was developed by an interdisciplinary group of investigators. This interview was administered in an acute care hospital to 50 patients who were over the age of 65 years. Results from the interview were compared to assessments of major symptoms of delirium made independently by a neurologist and a psychiatrist. This interview had good validity and reliability. The sensitivity of the DSI was .90 and the specificity was .80, when compared with the clinical judgment of a psychiatrist and neurologist. Interrater reliability, using lay interviewers, was .90 for the detection of major symptoms of delirium. These results indicate that the DSI could be used by lay interviewers to assess reliably the symptoms of delirium.

Assessment scales for delirium: A review

“…As delirium occurs in medical surgical setting and it is not possible to screen all patients for delirum by mental health 60 August 22, 2012|Volume 2|Issue 4| WJP|www.wjgnet.com Table 1 Scales for assessment of delirium in clinical and research setting Instruments for assessment of arousability of the patient RASS [9] Instruments for screening for premorbid cognitive disturbances IQCODE [10,11] Screening instruments NEECHAM Confusion Scale [12] Nursing Delirium Screening Scale [13] Delirium Observation Screening Scale/Delirium Observation Scale [14,15] Intensive care delirium screening checklist [16] Pediatric Anesthesia Emergence Delirium scale [17] Global Attentiveness Rating [18] Diagnostic instruments Delirium Symptom Interview [19] Saskatoon Delirium Checklist [20] Delirium Rating Scale-revised version [21] Memorial Delirium Assessment Scale [22] Confusion Assessment Method [23] CAM-ICU [24,25] Paediatrics CAM-ICU [26] Clinical Assessment of Confusion -A and B [27,28] Instruments for Assessment of severity of delirium Delirium Rating Scale [29] Delirium Rating Scale-Revised-98 [21] Confusion Assessment Method [23] Confusion Assessment Method for Intensive Care Unit assessment tool [24,25] Delirium-O-Meter [30] Delirium Index [31] Memorial Delirium Assessment Scale [22] Confusional State Evaluation Scale [32] Delirium Assessment Scale [33] Delirium Severity Scale [34] Instruments for assessment of cognitive symptoms only Mini Mental Status Examination [35] Cognitive Test for Delirium [36,37...…”

“…Cognitive Test for Delirium [36,37] DSM-Ⅲ-R 9 Research assistant 10-15 Delirium Assessment Scale [33] DSM-Ⅲ 8 Physicians √ Delirium Index [31] DSM-Ⅲ-R 7 Research assistant 5-10 √ Delirium Observation Screening Scale [14,15] DSM-Ⅳ 25 Research assistant 5-10 √ Delirium Observation Scale [14,15] DSM-Ⅳ 13 Nurses < 5 √ Delirium Rating Scale [29] DSM-Ⅲ 10 Trained clinicians √ Delirium Symptom Interview [19] DSM-Ⅲ 109 Trained interviewer 15 √ √ Delirium Severity Scale [34] Research assistant 10 √ Memorial Delirium Assessment Scale [22] DSM-Ⅳ 10 Physicians 10-15 √ NEECHAM Confusion Scale [12] Research 9 Nurses 10 √ Delirium Rating Scale-Revised-98 [21] DSM-Ⅳ 16 Psychiatrists Nursing Delirium Screening Scale [13] 5 Nurses 1 √ √ Intensive care delirium screening checklist [16] DSM-Ⅳ 8 Non-specialist staff 7-10 Pediatric Anesthesia Emergence Delirium scale [17] 5 Saskatoon Delirium Checklist [20] DSM-Ⅲ 10 Clinician < 15 √ Delirium-O-Meter [30] DSM-Ⅳ 12 Limited training √ Confusion assessment method for intensive care unit assessment tool [24,25] DSM-Ⅳ 9 Trained health professional …”

Risk factors of delirium in elderly patients with hip fracture

“…However, the current 'gold standard' for assessing delirium are the diagnostic criteria set by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) [39]. Other less commonly used diagnostic tools that feature different use of DSM criteria include the Organic Brain Syndrome Scale (OBS scale) [40] and the Delirium Symptom Interview (DSI) [41]. Severity scales designed for use by experts with significant professional training were the delirium Rating Scale (DRS-R-98) [42] and Memorial Delirium Assessment Scale (MDAS) [43].…”

Differential effects of delirium on fluid and crystallized cognitive abilities

“…To aid assessment of these features the experimenter administered a battery of instruments validated for this purpose (Simon et al, 2006). This comprised the mini-mental state examination (MMSE) to measure general cognitive function (Folstein et al, 1975); digit span forwards (3-5 digits) and backwards (3-4 digits) and reciting the days of the week and months of the year backwards to measure attention; and the delirium symptom interview (Albert et al, 1992) to determine patients' behavior and experiences over the preceding 24 hours. Medical and nursing staff and patients' clinical notes were also consulted to aid with diagnosis.…”