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The Relation Between the Clinical Subtypes of Delirium and the Urinary Level of 6-SMT

Received September 25, 2001; revised February 26, 2002; accepted March 19, 2002. From the Shmuel Harofe Hospital, Geriatric Medical Center, affiliated with the Sackler School of Medicine, Tel-Aviv University; Beer Yacov, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel, Endocrinological Laboratory, Rambam Hospital, Haifa, Israel, Sleep Laboratory, Assaf Harofeh Medical Center, Tzrifin, Israel. Address correspondence to Dr. Silviu Balan, Shmuel Harofeh Hospital, Geriatric Medical Center Beer Yacov No. 2, Israel, code 70300; shmuelh{at}netvision.net.il (E-mail).

Delirium is a common syndrome among hospitalized elderly patients. In humans, sleep and circadian rhythms are disturbed during delirium, and both are influenced by the hormone melatonin. This prompted us to investigate the relationship of the clinical subtypes of delirium: 1) hyperactive, 2) hypoactive, and 3) mixed, with melatonin, as reflected by a patient's urinary metabolite 6-SMT. Results support our hypothesis that urinary 6-SMT during delirium was higher in hypoactive and lower in hyperactive patients. Because this is the first time a biochemical parameter related to the clinical subtypes of delirium has been reported, further research on the link between melatonin and delirium is necessary.

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