Impact of Classification Systems (DSM-5, DSM-IV, CAM and DRS-R98) on Outcomes of Delirium

2017 ◽  
Author(s):  
Geraldine McCarthy
Keyword(s):  
Classification Systems ◽  
Dsm 5 ◽  
Dsm Iv

Hebephrenia: a conceptual history

2012 ◽  
Vol 23 (4) ◽  
pp. 387-403 ◽  
Author(s):  
Abdullah Kraam ◽  
Paula Phillips
Keyword(s):  
Emotional Expression ◽  
Historical Context ◽  
Classification Systems ◽  
Late Nineteenth Century ◽  
Conceptual History ◽  
Dsm 5 ◽  
History Of ◽  
Dsm Iv ◽  
Characteristic Features ◽  
Psychiatric Establishment

This paper traces the conceptual history of hebephrenia from the late nineteenth century until it became firmly embedded into modern psychiatric classification systems. During this examination of the origins and the historical context of hebephrenia it will be demonstrated how it became inextricably linked with twentieth-century notions of schizophrenia. The first detailed description of hebephrenia in 1871 by Ewald Hecker, then a virtually unknown German psychiatrist, created a furore in the psychiatric establishment. Within a decade hebephrenia was a firmly embedded concept of adolescent insanity. Daraszkiewicz, Kraepelin’s brilliant assistant in Dorpat, broadened Hecker’s concept of hebephrenia by including severe forms. This paved the way for Kraepelin to incorporate it together with catatonia as a subtype of dementia praecox. We recognize Hecker’s hebephrenia in DSM-IV as schizophrenia, disorganized type. Although DSM-5 will probably abolish subtypes of schizophrenia, characteristic features of hebephrenia will be found within the proposed domains of disorganization, restricted emotional expression and avolition.

Delirium classification by the diagnostic and statistical manual – a moving target

2015 ◽  
Vol 27 (6) ◽  
pp. 881-882 ◽  
Author(s):  
Karin J. Neufeld
Keyword(s):  
Rating Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Classification Systems ◽  
Diagnostic Systems ◽  
Delirium Assessment ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Medical Inpatients ◽  
Dsm Iv

The following paper, entitled “A Comparison of Delirium Diagnosis in Elderly Medical Inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 Criteria” by Adamis and colleagues, reports the results of a single delirium assessment of 200 medical inpatients, aged 70 years and older. The aim was to compare the prevalence of delirium using two different diagnostic classification systems (DSM-5 and DSM-IV) and two commonly used research tools (Confusion Assessment Method and the Delirium Rating Scale-Revised ‘98). This editorial focuses on the comparison of the two versions of the DSM. The authors conclude that, while both diagnostic systems identify a core concept of delirium, the DSM-IV criteria are the most inclusive of the four approaches and the DSM-5, the most restrictive, identifying a prevalence of 19.5% and 13%, respectively in this sample. Furthermore, they conclude that these two systems do not appear to detect the same patients: only 14 of 26 (54%) individuals identified as delirious by the more exclusive DSM-5 criteria were also identified as such by DSM-IV.

A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria

2015 ◽  
Vol 27 (6) ◽  
pp. 883-889 ◽  
Author(s):  
Dimitrios Adamis ◽  
Siobhan Rooney ◽  
David Meagher ◽  
Owen Mulligan ◽  
Geraldine McCarthy
Keyword(s):  
Diagnostic Method ◽  
Correlation Coefficients ◽  
Classification Systems ◽  
Case Identification ◽  
Significant Agreement ◽  
Dsm 5 ◽  
Detailed Evaluation ◽  
Medical Inpatients ◽  
Dsm Iv ◽  
Medical Teams

ABSTRACTBackground:The recently published DSM-5 criteria for delirium may lead to different case identification and rates of delirium than previous classifications. The aims of this study are to determine how the new DSM-5 criteria compare with DSM-IV in identification of delirium in elderly medical inpatients and to investigate the agreement between different methods, using CAM, DRS-R98, DSM-IV, and DSM-5 criteria.Methods:Prospective, observational study of elderly patients aged 70+ admitted under the acute medical teams in a regional general hospital. Each participant was assessed within 3 days of admission using the DSM-5, and DSM-IV criteria plus the DRS-R98, and CAM scales.Results:We assessed 200 patients [mean age 81.1±6.5; 50% female; pre-existing cognitive impairment in 63%]. The prevalence rates of delirium for each diagnostic method were: 13.0% (n = 26) for DSM-5; 19.5% (n = 39) for DSM-IV; 13.5% (n = 27) for DRS-R98 and 17.0%, (n = 34) for CAM. Using tetrachoric correlation coefficients the agreement between DSM-5 and DSM-IV was statistically significant (ρtetr = 0.64, SE = 0.1, p < 0.0001). Similar significant agreement was found between the four methods.Conclusions:DSM-IV is the most inclusive diagnostic method for delirium, while DSM-5 is the most restrictive. In addition, these classification systems identify different cases of delirium. This could have clinical, financial, and research implications. However, both classification systems have significant agreement in the identification of the same concept (delirium). Clarity of diagnosis is required for classification but also further research considering the relevance in predicting outcomes can allow for more detailed evaluation of the DSM-5 criteria.

A comparison of outcomes according to different diagnostic systems for delirium (DSM-5, DSM-IV, CAM, and DRS-R98)

2017 ◽  
Vol 30 (4) ◽  
pp. 591-596 ◽  
Author(s):  
Dimitrios Adamis ◽  
David Meagher ◽  
Siobhan Rooney ◽  
Owen Mulligan ◽  
Geraldine McCarthy
Keyword(s):  
Care Home ◽  
Length Of Hospital Stay ◽  
Classification Systems ◽  
Diagnostic Systems ◽  
Prospective Longitudinal Study ◽  
Cognitive Improvement ◽  
Dsm 5 ◽  
Dsm Iv ◽  
Medical Wards ◽  
Prospective Longitudinal

ABSTRACTStudies indicate that DSM-5 criteria for delirium are relatively restrictive, and identify different cases of delirium compared with previous systems. We evaluate four outcomes of delirium (mortality, length of hospital stay, institutionalization, and cognitive improvement) in relation to delirium defined by different DSM classification systems.Prospective, longitudinal study of patients aged 70+ admitted to medical wards of a general hospital. Participants were assessed up to a maximum of four times during two weeks, using DSM-5 and DSM-IV criteria, DRS-R98 and CAM scales as proxies for DSM III-R and DSM III.Of the 200 assessed patients (mean age 81.1, SD = 6.5; and 50% female) during hospitalization, delirium was identified in 41 (20.5%) using DSM-5, 45 (22.5%) according to DSM-IV, 46 (23%) with CAM positive, and 37 (18.5%) with DRS-R98 severity score >15. Mortality was significantly associated with delirium according to any classification system, but those identified with DSM-5 were at greater risk. Length of stay was significantly longer for those with DSM-IV delirium. Discharge to a care home was associated only with DRS-R98 defined delirium. Cognitive improvement was only associated with CAM and DSM-IV. Different classification systems for delirium identify populations with different outcomes.

Impact of classification systems (DSM-5, DSM-IV, CAM and DRS-R98) on outcomes of delirium

2017 ◽  
Vol 41 (S1) ◽  
pp. s496-s497
Author(s):  
G. McCarthy ◽  
D. Meagher ◽  
D. Adamis
Keyword(s):  
Length Of Stay ◽  
Diagnostic Method ◽  
Hospital Length ◽  
Classification Systems ◽  
University Hospital ◽  
Hospital Length Of Stay ◽  
Discharge Destination ◽  
Dsm 5 ◽  
Dsm Iv ◽  
Prospective Longitudinal

IntroductionPrevious studies showed different classification systems lead to different case identification and rates of delirium. No one has previously investigated the influence of different classification systems on the outcomes of delirium.Aims and objectivesTo determine the influence of DSM-5 criteria vs. DSM-IV on delirium outcomes (mortality, length of stay, institutionalisation) including DSM-III and DSM-IIR criteria, using CAM and DRS-R98 as proxies.MethodologyProspective, longitudinal, observational study of elderly patients 70+ admitted to acute medical wards in Sligo University Hospital. Participants were assessed within 3 days of admission using DSM-5, and DSM-IV criteria, DRS-R98, and CAM scales.ResultsTwo hundred patients [mean age 81.1 ± 6.5; 50% female]. Rates (prevalence and incidence) of delirium for each diagnostic method were: 20.5% (n = 41) for DSM-5; 22.5% (n = 45) for DSM-IV; 18.5% (n = 37) for DRS-R98 and 22.5%, (n = 45) for CAM. The odds ratio (OR) for mortality (each diagnostic method respectively) were: 3.37, 3.11, 2.42, 2.96. Breslow-Day test on homogeneity of OR was not significant x2= 0.43, df: 3, P = 0.93. Those identified with delirium using the DSM-IV, DRS-R98 and CAM had significantly longer hospital length of stay(los) compared to those without delirium but not with those identified by DSM-5 criteria. Re-institutionalisation, those identified with delirium using DSM-5, DSM-IV and CAM did not have significant differences in discharge destination compared to those without delirium, those identified with delirium using DRS-R98 were more likely discharged to an institution (z = 2.12, P = 0.03)ConclusionAssuming a direct association between delirium and examined outcomes (mortality, los and discharge destination) different classification systems for delirium identify populations with different outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Autismus-Spektrum Störung nach DSM-5

2014 ◽  
Vol 42 (3) ◽  
pp. 185-192 ◽  
Author(s):  
Christine M. Freitag
Keyword(s):  
Dsm 5 ◽  
Icd 10 ◽  
Dsm Iv

Die Autismus-Spektrum Störung (ASS) wird in DSM-5 als eine Erkrankung aus den ICD-10 bzw. DSM-IV TR-Diagnosen frühkindlicher Autismus, Asperger Syndrom und atypischer Autismus/PDD-nos zusammengefasst und weist entsprechend revidierte Kriterien auf. In dem vorliegenden Artikel werden diese Kriterien vergleichend dargestellt, Studien zu Validität und Reliabilität der neuen ASS-Diagnose präsentiert und offene Fragen diskutiert. Ein Ausblick auf die klinische und wissenschaftliche Bedeutung wird gegeben.

Veränderungen in der Prävalenz substanzbezogener Störungen durch den Wechsel von DSM-IV zu DSM-5

Suchttherapie ◽  
2015 ◽  
Vol 16 (S 01) ◽  
Author(s):  
D Piontek ◽  
E Gomes de Matos ◽  
L Kraus
Keyword(s):  
Dsm 5 ◽  
Dsm Iv

Suchterkrankungen im Diagnostischen und Statistischen Manual Psychischer Störungen DSM-5

2015 ◽  
Vol 12 (02) ◽  
pp. 110-117
Author(s):  
O. Pogarell ◽  
G. Koller
Keyword(s):  
Addictive Disorders ◽  
Dsm 5 ◽  
Icd 10 ◽  
Dsm Iv

Zusammenfassung Hintergrund: Im Jahr 2014 wurde das DSM-IV durch die fünfte Version des Diagnostischen und Statistischen Manuals Psychischer Störungen (DSM-5) abgelöst. In der vorliegenden Übersicht soll auf die Darstellung der Abhängigkeitserkrankungen im DSM-5 (Kapitel: Substance Related and Addictive Disorders, in der Übersetzung: Störungen im Zusammenhang mit psychotropen Substanzen und abhängige Verhaltensweisen) eingegangen werden. Ziel: Nach einem Überblick über die neue Systematik werden die entsprechenden Änderungen und Besonderheiten gegenüber DSM-IV und ICD-10 erläutert, sowie die Rezeption im deutschsprachigen Raum dargestellt.

Historische Entwicklung, Diagnostik und Klassifikation der Somatoformen Störungen – Vergleich von ICD-10, DSM-IV-TR und DSM-5

2014 ◽  
Vol 11 (03) ◽  
pp. 149-155
Author(s):  
M. Zaudig
Keyword(s):  
Anxiety Disorder ◽  
Somatic Symptom ◽  
Somatic Symptom Disorder ◽  
Historische Entwicklung ◽  
Dsm 5 ◽  
Illness Anxiety Disorder ◽  
Icd 10 ◽  
Dsm Iv ◽  
Illness Anxiety

ZusammenfassungDer vorliegende Artikel beschreibt die aktuellen diagnostischen Entwicklungen im Bereich der Somatoformen Störung unter Zugrundelegung der aktuellen S3-Leitlinien für „Nichtspezifische funktionelle und somatoforme Körperbeschwerden“ und der historischen Entwicklung der Somatoformen Störungen (einschließlich der Hypochondrie). Neben einem Vergleich von ICD-10 mit DSM-IV-TR und DSM-5 werden die neuen Kriterien für Somatic Symptom Disorder und Illness Anxiety Disorder (vormals Hypochondrie) nach DSM-5 vorgestellt und diskutiert.

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