Symptom profile of delirium in children and adolescent—does it differ from adults and elderly? Sandeep Grover, M.D. ⁎ , Natasha Kate, M.D., Savita Malhotra, M.D., Subho Chakrabarti, M.D., F.R.C.Psych., Surendra Kumar Mattoo, M.D., Ajit Avasthi, M.D. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Received 8 February 2012; accepted 6 March 2012 Abstract Objective: The objective was to evaluate the phenomenology, etiology and outcome of delirium in children and adolescents (8–18 years of age) seen in a consultation–liaison psychiatric service in India. Additionally, an attempt was made to compare the phenomenology with adult and elderly patients with delirium. Method: Thirty children and adolescents (age 8–18 years) diagnosed with delirium by the consultation–liaison psychiatry team were rated on the Delirium Rating Scale-Revised-98 (DRS-R-98) and compared with DRS-R-98 data on 120 adults and 109 elderly patients. Results: The commonly observed symptoms in children and adolescents with delirium were disturbance in attention, orientation, sleep–wake cycle disturbances, fluctuation of symptoms, disturbance of short-term memory and motor agitation. The least commonly seen symptoms included delusions and motor retardation. Compared to adults, children and adolescents had lower frequency of long-term memory and visuospatial disturbances. Compared to the elderly, children and adolescents had higher frequency of lability of affect. For severity of symptoms, compared to adults, the children and adolescents had lower severity of sleep–wake disturbances, abnormality of thought, motor agitation, orientation, attention, short-term memory, long-term memory and visuospatial abilities. When compared to elderly patients, children and adolescents had higher severity of lability of affect and lower severity of language disturbances, short-term memory and visuospatial abilities. Conclusions: In general, phenomenology, of delirium in children and adolescents (age 8–18 years) is similar to that seen in adults and elderly patients. © 2012 Elsevier Inc. All rights reserved. Keywords: Delirium; Children and adolescents; Phenomenology 1. Introduction As a neuropsychiatric condition, delirium is associated with many negative consequences such as increased morbidity, mortality, prolonged hospital stay and higher health care costs in adults and elderly [1,2]. The database for delirium for adults and elderly is large, but limited for children and adolescents. A recent review noted that the latter is limited to case reports and small case series, and the total number of cases described in literature from 1980 to March 2009 included 217 children and adolescents with definite [meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV- TR) criteria] delirium and 136 children and adolescents with probable delirium [3]. Following this review, studies describing the clinical characteristics of delirium in children and adolescents have included a retrospective study from India with 46 children aged ≤14 years [4]; a prospective study of 23 cases aged up to 16 years [5]; a study of 49 patients from a pediatric intensive care unit (ICU) [6];a study of 26 patients aged up to 17 years evaluating the usefulness of the Pediatric Anesthesia Emergence Delirium Scale (PAED), the Delirium Rating Scale-88 and the Delirium Rating Scale-Revised R-98 (DRS-R-98) [7]; and a study of 68 children and adolescents for the validity and reliability of the Pediatric Confusional Assessment Method Available online at www.sciencedirect.com General Hospital Psychiatry 34 (2012) 626 – 632 ⁎ Corresponding author. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Tel.: +91 172 2756807; fax: +91 172 2744401; 2745078. E-mail address: drsandeepg2002@yahoo.com (S. Grover). 0163-8343/$ – see front matter © 2012 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.genhosppsych.2012.03.003