Korean J Psychosom Med.  2019 Dec;27(2):111-118. 10.22722/KJPM.2019.27.2.111.

Clinical Features Affecting Antipsychotic Prescription for Delirium Patients

Affiliations
  • 1Keyo Hospital, Uiwang, Korea. suehime@gmail.com
  • 2Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 3Addiction Center, Keyo Hospital, Uiwang, Korea.

Abstract


OBJECTIVES
The purpose of this study was to investigate the clinical characteristics of antipsychotic medication prescription for the symptom control in patients with delirium.
METHODS
One hundred and eighty-five patients referred to consultation-liaison psychiatric services for delirium due to general medical condition were included in this study. All subjects were divided into two groups (antipsychotics users vs. antipsychotics nonusers), and comparison analyses on their clinical characteristics were performed.
RESULTS
One hundred and twenty nine patients (66.5%) used antipsychotics for their delirium, and 56 patients (30.3%) did not use antipsychotics. The history of psychotropic medication was more frequently observed in antipsychotic users (5.4% vs. 18.6%, χ²=5.498, p=0.022). Especially, the history of benzodiazepine use was significantly high in antipsychotics users. The total score and sub-items of delirium rating scale-severity items except for the psychomotor retardation item showed higher scores in antipsychotic users than in nonusers (all p<0.05). The total score of the delirium rating scale-diagnosis items was higher in antipsychotic users than in the nonusers (p=0.010).
CONCLUSIONS
Delirium patients with more severe delirium symptoms and with more history of benzodiazepine use were treated with antipsychotics more frequently than those without. These findings imply that benzodiazepine may not only exacerbate delirium but be associated with aggression or psychomotor agitation that need immediate intervention. Clinicians may need to pay attention not only these external symptoms but also to hypoactive symptoms that may lead to misdiagnosis and undertreatment.

Keyword

Delirium; Treatment; Antipsychotics; Delirium rating scale

MeSH Terms

Aggression
Antipsychotic Agents
Benzodiazepines
Delirium*
Diagnostic Errors
Humans
Morinda
Prescriptions*
Psychomotor Agitation
Antipsychotic Agents
Benzodiazepines
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