A study led by Cleveland Clinic found diagnostic agreement between primary services and consultation-liaison psychiatry for delirium was 88%, compared to 67% for strict depression diagnoses.
The multisite study was published Dev. 5 in the Journal of Psychosomatic Research. Cleveland Clinic researchers examined how often hospitalized patients are diagnosed with depression or delirium, highlighting ongoing diagnostic challenges for nonpsychiatric clinicians.
They conducted a chart review of almost 1,000 inpatient referrals made to consultation-liaison psychiatry services for suspected depression or delirium, comparing initial diagnoses from medical and surgical teams with final psychiatric evaluations.
Here are four things to know:
- When depression was broadened to include adjustment disorders, agreement increased to 80%.
- Among patients referred for depression who did not ultimately receive that diagnosis, nearly half were diagnosed with adjustment disorder. Other final diagnoses included anxiety disorders, delirium and neurocognitive issues.
- For every 10-year increase in age, the odds of being misdiagnosed with depression decreased by up to 20%, suggesting expanded geriatric education may be contributing to improved accuracy.
- Patients taking psychotropic medications were more than twice as likely to have delirium misdiagnosed as depression, suggesting medication lists may unintentionally influence clinical judgment.
