Prevalence of attention deficit hyperactivity disorder in an adult mental health service in the Republic of Ireland.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is well recognised in childhood. However, recognition that it commonly persists into adulthood is relatively recent This study is the 2nd phase of a two-phase epidemiological investigation of the prevalence of adult ADHD in outpatients in Ireland.

Method: In phase-1, 634 participants were screened with Adult ADHD Self-Report Scale (ASRS) and Wender Utah Rating Scale (WURS).

ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics.

Objective: Systematic review and meta-analysis to estimate the pooled prevalence of ADHD in adult attendees of outpatient mental health clinics and to investigate factors influencing prevalence rates.

Methods: The following were extracted: demographics, design of the study (screening only or two-phase), scales/criteria for diagnosis of ADHD, number of ADHD, and non-ADHD participants.

Results: The pooled prevalence of ADHD from screening studies ( = 9) was 26.

Domains of delirium severity in Alzheimer's disease and related dementias.

Background: The ability to rate delirium severity is key to providing optimal care for persons with Alzheimer's Disease and Related Dementias (ADRD). Such ratings would allow clinicians to assess response to treatment, recovery time and prognosis, nursing burden and staffing needs, and to provide nuanced, appropriate patient-centered care. Given the lack of existing tools, we defined content domains for a new delirium severity instrument for use in individuals with mild to moderate ADRD, the DEL-S-AD.

Towards understanding the nature and need of delirium guidelines across nations and cultures.

Background: Delirium is associated with a variety of adverse healthcare outcomes but is highly predictable, preventable and treatable. For this reason, numerous guidelines have been developed for delirium recognition, prevention and management across different countries and disciplines. Although research is adduced as evidence for these guidelines, a constant finding is the lack of implementation if they exist at all.

Is the behavioral component in the Family Assessment Device uni- or multidimensional?

The Family Assessment Device is a tool that helps to see the extent of family functioning, and there have been many published articles concerning its psychometric properties. However, the Behavior Control subscale has shown consistent low Cronbach's α scores which suggests that this component may be multidimensional in construct.

The trajectory of C-reactive protein serum levels in older hip fracture patients with postoperative delirium.

Objectives: Important precipitating risk factors for delirium such as infections, vascular disorders, and surgery are accompanied by a systemic inflammatory response. Systemic inflammatory mediators can induce delirium in susceptible individuals. Little is known about the trajectory of systemic inflammatory markers and their role in the development and outcome of delirium.

The Greek version of the McMaster Family Assessment Device.

The Family Assessment Device (FAD) is a self-report questionnaire, developed to assess the six dimensions of the McMaster Model of Family Functioning. It has been translated into the Greek language but never validated. We aimed to evaluate the psychometric properties of the Greek version of the FAD in a nonclinical sample.

General practitioners' (GP) attitudes and knowledge about attention deficit hyperactivity disorder (ADHD) in Ireland.

Background: ADHD is the most frequent reason for attendance at Child and Adolescent Mental Health Services (CAMHS). General practitioners (GPs) play a key role in recognising symptoms, referring for assessment and supporting ongoing treatment. However, there is an ambiguous understanding of ADHD among GPs, and different attitudes regarding the validity of ADHD as a construct.

Low peripheral levels of insulin growth factor-1 are associated with high incidence of delirium among elderly patients: A systematic review and meta-analysis.

Introduction: Delirium, a serious condition observed in critically ill patients, clinically presents with impaired cognition and consciousness. The relationship between delirium and peripheral levels of insulin growth factor-1 (IGF-1) is unclear. Thus we conducted a meta-analysis to address this issue.

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium.

Motor disturbances in delirious patients are common, but their relationship to cognition and severity of illness has not been studied. We examined motor subtypes in an older age inpatient population, their relationship to clinical variables including delirium, and their association with 1-year mortality in a prospective study, using the Confusion Assessment Method, Acute Physiology and Chronic Health Evaluation II, Montreal Cognitive Assessment (MoCA), Barthel Index, and Delirium Rating Scale-Revised 98 (DRS-R98). Motor subtypes were evaluated using 2 items of DRS-R98.

The Association of Serum Levels of Brain-Derived Neurotrophic Factor with the Occurrence of and Recovery from Delirium in Older Medical Inpatients.

Limited studies of the association between BDNF levels and delirium have given inconclusive results. This prospective, longitudinal study examined the relationship between BDNF levels and the occurrence of and recovery from delirium. Participants were assessed twice weekly using MoCA, DRS-R98, and APACHE II scales.

Sleep-wake cycle disturbances in elderly acute general medical inpatients: Longitudinal relationship to delirium and dementia.

Introduction: Sleep disturbances in elderly medical inpatients are common, but their relationship to delirium and dementia has not been studied.

Methods: Sleep and delirium status were assessed daily for a week in 145 consecutive newly admitted elderly acute general hospital patients using the Delirium Rating Scale-Revised-98 (DRS-R98), Diagnostic and Statistical Manual 5, and Richards-Campbell Sleep Quality Scale measures. The longitudinal relationship between DRS-R98 and Richards-Campbell Sleep Quality Scale sleep scores and delirium, also with dementia as a covariate, was evaluated using generalized estimating equation logistic regression.

Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents.

Introduction: Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles.

Methods: Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98).

Variability of Delirium Motor Subtype Scale-Defined Delirium Motor Subtypes in Elderly Adults with Hip Fracture: A Longitudinal Study.

Objectives: To examine changes in motor subtype profile in individuals with delirium.

Design: Observational, longitudinal study; substudy of a multicenter, randomized controlled trial.

Setting: Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands.

Comparison of cognitive and neuropsychiatric profiles in hospitalised elderly medical patients with delirium, dementia and comorbid delirium-dementia.

Objectives: Differentiation of delirium and dementia is a key diagnostic challenge but there has been limited study of features that distinguish these conditions. We examined neuropsychiatric and neuropsychological symptoms in elderly medical inpatients to identify features that distinguish major neurocognitive disorders.

Setting: University teaching hospital in Ireland.

Evaluating attention in delirium: A comparison of bedside tests of attention.

Aim: Impaired attention is a core diagnostic feature for delirium. The present study examined the discriminating properties for patients with delirium versus those with dementia and/or no neurocognitive disorder of four objective tests of attention: digit span, vigilance "A" test, serial 7s subtraction and months of the year backwards together with global clinical subjective rating of attention.

Methods: This as a prospective study of older patients admitted consecutively in a general hospital.

Delirium, how does it end? Mortality as an outcome in older medical inpatients.

Objectives: Delirium is associated with poor outcomes. Previous research in delirium and mortality gave rather inconclusive results. This study aims to find out the rates of mortality at 1 year and the factors associated with it in a cohort of hospitalized older patients.

The utility of the clock drawing test in detection of delirium in elderly hospitalised patients.

Objectives: Delirium is common neuropsychiatric condition among elderly inpatients. The clock drawing test (CDT) has been used widely as bedside screening tool in assessing cognitive impairment in elderly people. Previous studies which evaluate its usefulness in delirium reported conflicting results.

Defining 'recovery' for delirium research: a systematic review.

Background: Delirium is a common neuropsychiatric disorder. The natural course is of an acute, fluctuating and often transient condition; however, accumulating evidence suggests that delirium can be associated with incomplete recovery. Despite a growing body of research, a lack of clarity exists regarding definition and outcomes.

Frequency of delirium and subsyndromal delirium in an adult acute hospital population.

Background The frequency of full syndromal and subsyndromal delirium is understudied. Aims We conducted a point prevalence study in a general hospital. Method Possible delirium identified by testing for inattention was evaluated regarding delirium status (full/subsyndromal delirium) using categorical (Confusion Assessment Method (CAM), DSM-IV) and dimensional (Delirium Rating Scale-Revised-98 (DRS-R98) scores) methods.

Phenomenological and biological correlates of improved cognitive function in hospitalized elderly medical inpatients.

Deterioration of cognitive ability is a recognized outcome following acute illness in older patients. Levels of circulating cytokines and APOE genotype have both been linked with acute illness-related cognitive decline. In this observational longitudinal study, consecutive admissions to an elderly medical unit of patients aged ≥70 years were assessed within 3 days and re-assessed twice weekly with a range of scales assessing cognitive function, functional status and illness severity.

An analytical framework for delirium research in palliative care settings: integrated epidemiologic, clinician-researcher, and knowledge user perspectives.

Context: Delirium often presents difficult management challenges in the context of goals of care in palliative care settings.

Objectives: The aim was to formulate an analytical framework for further research on delirium in palliative care settings, prioritize the associated research questions, discuss the inherent methodological challenges associated with relevant studies, and outline the next steps in a program of delirium research.

Methods: We combined multidisciplinary input from delirium researchers and knowledge users at an international delirium study planning meeting, relevant literature searches, focused input of epidemiologic expertise, and a meeting participant and coauthor survey to formulate a conceptual research framework and prioritize research questions.

Development of an abbreviated version of the delirium motor subtyping scale (DMSS-4).

Background: Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Identification of clinical subtypes can allow for more targeted clinical and research efforts. We sought to develop a brief method for clinical subtyping in clinical and research settings.

Ethical challenges and solutions regarding delirium studies in palliative care.

Context: Delirium occurs commonly in settings of palliative care (PC), in which patient vulnerability in the unique context of end-of-life care and delirium-associated impairment of decision-making capacity may together present many ethical challenges.

Objectives: Based on deliberations at the Studies to Understand Delirium in Palliative Care Settings (SUNDIPS) meeting and an associated literature review, this article discusses ethical issues central to the conduct of research on delirious PC patients.

Methods: Together with an analysis of the ethical deliberations at the SUNDIPS meeting, we conducted a narrative literature review by key words searching of relevant databases and a subsequent hand search of initially identified articles.

Reliability of delirium rating scale (DRS) and delirium rating scale-revised-98 (DRS-R98) using variance-based multivariate modelling.

Delirium's characteristic fluctuation in symptom severity complicates the assessment of test-retest reliability of scales using classical analyses, but application of modelling to longitudinal data offers a new approach. We evaluated test-retest reliability of the delirium rating scale (DRS) and delirium rating scale-revised-98 (DRS-R98), two widely used instruments with high validity and inter-rater reliability. Two existing longitudinal datasets for each scale included DSM-IV criteria for delirium diagnosis and repeated measurements using the DRS or DRS-R98.