한국판 섬망 평가 척도-98(K-DRS-98)을 이용한 섬망의 진단과 심각도 그리고 아형에 관한 연구
A Study for the Diagnosis, Severity and Subtypes of Delirium Using the Korean Version of Delirium Rating Scale-Revised-98(K-DRS-98)
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본 연구는 섬망의 진단 및 심각도, 아형을 평가하는데 있어서 한국판 섬망 평가 척도-98(K-DRS-98)이 유 용성이 있는지를 알아보기 위해 시행되었다. DSM-Ⅳ의 진단 기준에 의해 섬망으로 진단된 92명 의 환자들로부터 의학 정보를 수집하여 섬망 환자들을 평가하였다. 진단 유용성은 K-DRS-98과 CAM을 비 교하였고, 심각도는 K-DRS 및 MMSE-K와 비교하였 다. 아형의 구별은 Liptzin과 Levkoff의 Phenomenolo ¬gic subtypes of delirium을 기준으로 하였다. K-DRS-98과 CAM의 진단적 일치도는 (κ)=0.455 (p<0.001)이었다. K-DRS-98의 총점과 K-DRS의 총점은 양의 상관관계, 그리고 MMSE-K의 총점과는 음의 상관관계를 보였다. 혼합형 아형은 K-DRS-98의 총점과 언어의 이상 항목의 점수가 높을 경우, 과활성형 아형은 운동성 지체의 점수가 낮을 경우, 그리고 저활성 형 아형은 사고 과정 또는 운동성 초조 항목의 점수가 낮을 경우 가능성이 높았다. K-DRS-98은 다양한 증상 범위의 섬망 진단 및 심 각도에 관한 유용한 측정 도구이며, 아형을 구별하는 데에도 도움을 줄 수 있을 것이다.
Abstract
Objectives：The aim of this study was to examine the Korean version of Delirium Rating Scale-Revised-98(K¬DRS-98) whether it can be a useful instrument for diagnosis, severity, and clinical subtypes of delirium. Methods：In this study, 92 patients were eligible to participate. These patients were consecutive referrals from January 2007 to August 2007, and met DSM-IV diagnostic criteria for delirium. K-DRS-98 was compared to the CAM for diagnostic consistency, to the K-DRS and the MMSE-K for correlation of severity, and to the Phenomeno¬logic subtypes of delirium by Liptzin & Levkoff for the relationship between each items of K-DRS-98 and clinical subtypes of delirium. Results：The diagnostic consistency was κ =0.455. The total score of K-DRS-98 was correlated with the total score of K-DRS positively and with the total score of MMSE-K negatively. It was shown that the mixed subtype of delirium was anticipated when the total score of K-DRS-98 and the score of the language item was higher, the hyperactive subtype when the score of the motor retardation item was lower, and the hypoactive subtype when the score of the thought process abnormalities or motor agitation items was lower. Conclusions：K-DRS-98 is a useful tool for identifying the subtypes of delirium as well as diagnosing delirium and assessing its severity.
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