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A New Data-Based Motor Subtype Schema for Delirium

Received March 20, 2007; revised July 25, 2007; accepted July 30, 2007. Dr. Meagher is affiliated with the University of Limerick Medical School in Limerick, Ireland. Drs. Meagher, Moran, Raju, and Leonard are affiliated with the Department of Adult Psychiatry at Midwestern Regional Hospital in Limerick. Dr. Donnelly is affiliated with the Milford Hospice Palliative Care Centre in Limerick. Dr. Saunders is affiliated with the Statistical Consulting Unit at the University of Limerick, in Limerick. Dr. Trzepacz is affiliated with the University of Mississippi Medical School in Jackson, Miss., Tufts University School of Medicine, in Boston, Mass., and Indiana University School of Medicine and Lilly Research Laboratories in Indianapolis, Indiana. Address correspondence to Professor David Meagher, Department of Health Systems Research, University of Limerick, and Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland; meaghermob{at}eircom.net (e-mail).

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.

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