Delirium Motor Subtypes

A New Data-Based Motor Subtype Schema for Delirium

The authors sought to validate a new approach to motor subtyping in delirium based on data from a controlled comparison of items from three existing psychomotor schema combined into the Delirium Motoric Checklist. Principal components analysis of the Delirium Motoric Checklist identified two factors that correlated significantly with independently assessed motor agitation and retardation. Symptoms loading at >0.65 were extracted to form subtype criteria composed of four hyperactive items and seven hypoactive items which, when applied to the delirious population, suggested a cutoff of two items for subtypes. This new scale is derived from existing approaches but is more concise, focused on motor disturbances, and validated against nondelirious comparison subjects and independently rated motor disturbance. J Neuropsychiatry Clin Neurosci Spring 2008;20(2):185-93.doi: 10.1176/jnp.2008.20.2.185. A new data-based motor subtype schema for delirium David Meagher 1Maria MoranBangaru RajuMaeve LeonardSinead DonnellyJean SaundersPaula Trzepacz

Hypoactive Subtype

if definite evidence in the previous 24 hours of (and this should be a deviation from pre-delirious baseline) two or more of:

• Decreased amount of activity

• Decreased speed of actions

• Reduced awareness of surroundings

• Decreased amount of speech

• Decreased speed of speech

• Listlessness

• Reduced alertness/withdrawal

*Where at least one of either decreased amount of activity or speed of actions is present.

How to differentiate hypo-active motor subtype of delirium from psychological depression?

It is very very difficult. Unless you check the physical signs.

How hard is it to simply measure respiratory rate as well as heart rate, blood pressure and body temperature and look at the circulation of your patient and look at body condition? Before talking with them about psychological issues and relationships and stuff….

to be continued……


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