A review of delirium rating scales

Delirium is a severe psychiatric syndrome that is highly prevalent in elderly general hospital patients. However, the diagnosis of delirium is often missed. The use of rating scales can be helpful in detecting and measuring delirium symptom severity. This article reviews recent developments with regard to psychometric qualities, measurement goal, content and rating procedures of some of the available rating scales in clinical practise. Studies that used delirium rating scales were searched for using the MEDLINE and subsequent examination of reference lists. Ten rating scales were selected for further evaluation. The Confusional Assessment Method (CAM), NEECHAM Confusion Scale (NEECHAM) and Delirium Observation Scale (DOS) appear to be most suitable as a screening instrument, depending on the type of rater (physician or nurse). The (revised) Delirium Rating Scale (DRS(-R-98)) seems to be particularly useful for measuring delirium severity or monitoring change.