Dimensions of psychosis in delirious and catatonic trauma critically Ill patients

Objective: We examined the effect of delirium and catatonia on psychosis symptom presentation in trauma intensive care unit (TICU) patients without previous history of serious psychiatric illness. Design: Prospective observational cohort study at a single academic medical center TICU, enrolling adul...

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Main Authors: Ming-Ray Xu, Trey W. McGonigle, Jinyuan Liu, Robert S. Dittus, Stephan Heckers, Pratik P. Pandharipande, Shawniqua Williams Roberson, Mayur B. Patel, E. Wesley Ely, Jo Ellen Wilson
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Biomarkers in Neuropsychiatry
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666144625000103
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author Ming-Ray Xu
Trey W. McGonigle
Jinyuan Liu
Robert S. Dittus
Stephan Heckers
Pratik P. Pandharipande
Shawniqua Williams Roberson
Mayur B. Patel
E. Wesley Ely
Jo Ellen Wilson
author_facet Ming-Ray Xu
Trey W. McGonigle
Jinyuan Liu
Robert S. Dittus
Stephan Heckers
Pratik P. Pandharipande
Shawniqua Williams Roberson
Mayur B. Patel
E. Wesley Ely
Jo Ellen Wilson
author_sort Ming-Ray Xu
collection DOAJ
description Objective: We examined the effect of delirium and catatonia on psychosis symptom presentation in trauma intensive care unit (TICU) patients without previous history of serious psychiatric illness. Design: Prospective observational cohort study at a single academic medical center TICU, enrolling adult patients with critical illness secondary to traumatic injury excluding patients with significant psychiatric history. ICU patients received once-daily DSM-5 delirium and catatonia evaluations, and Clinician-Related Dimensions of Psychosis Severity Scale (CRDPSS) assessment. Patients were grouped by delirium and/or catatonia diagnosis with Kruskal-Wallis and Pearson’s Chi-square testing of differences between groups in CRDPSS scores. Main Results: 74 patients were sorted into delirium and/or catatonia groups for the dimensions of psychosis analysis. Catatonia was common in this critically ill trauma population with 26 % prevalence. Patients with delirium and/or catatonia diagnoses had differing severities of psychosis symptoms from those with neither condition. CRDPSS total scores were significantly different between the groups (p = 0.011). Conclusions: Further investigation is needed to explore commonalities in the mechanisms underpinning ICU psychosis and to identify specific psychotic symptom manifestations suggestive of delirium versus catatonia.
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spelling doaj-art-4fce6722806f481bb2844c1a522a0ff12025-08-20T03:53:12ZengElsevierBiomarkers in Neuropsychiatry2666-14462025-06-011210012810.1016/j.bionps.2025.100128Dimensions of psychosis in delirious and catatonic trauma critically Ill patientsMing-Ray Xu0Trey W. McGonigle1Jinyuan Liu2Robert S. Dittus3Stephan Heckers4Pratik P. Pandharipande5Shawniqua Williams Roberson6Mayur B. Patel7E. Wesley Ely8Jo Ellen Wilson9Vanderbilt University School of Medicine, Nashville, TN, USA; Critical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA; Center for Health Services Research and the Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Services at the Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA; Center for Health Services Research and the Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USACritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA; Correspondence to: Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA.Objective: We examined the effect of delirium and catatonia on psychosis symptom presentation in trauma intensive care unit (TICU) patients without previous history of serious psychiatric illness. Design: Prospective observational cohort study at a single academic medical center TICU, enrolling adult patients with critical illness secondary to traumatic injury excluding patients with significant psychiatric history. ICU patients received once-daily DSM-5 delirium and catatonia evaluations, and Clinician-Related Dimensions of Psychosis Severity Scale (CRDPSS) assessment. Patients were grouped by delirium and/or catatonia diagnosis with Kruskal-Wallis and Pearson’s Chi-square testing of differences between groups in CRDPSS scores. Main Results: 74 patients were sorted into delirium and/or catatonia groups for the dimensions of psychosis analysis. Catatonia was common in this critically ill trauma population with 26 % prevalence. Patients with delirium and/or catatonia diagnoses had differing severities of psychosis symptoms from those with neither condition. CRDPSS total scores were significantly different between the groups (p = 0.011). Conclusions: Further investigation is needed to explore commonalities in the mechanisms underpinning ICU psychosis and to identify specific psychotic symptom manifestations suggestive of delirium versus catatonia.http://www.sciencedirect.com/science/article/pii/S2666144625000103DeliriumCatatoniaCritical illnessIntensive care unitTraumaPsychosis
spellingShingle Ming-Ray Xu
Trey W. McGonigle
Jinyuan Liu
Robert S. Dittus
Stephan Heckers
Pratik P. Pandharipande
Shawniqua Williams Roberson
Mayur B. Patel
E. Wesley Ely
Jo Ellen Wilson
Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
Biomarkers in Neuropsychiatry
Delirium
Catatonia
Critical illness
Intensive care unit
Trauma
Psychosis
title Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
title_full Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
title_fullStr Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
title_full_unstemmed Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
title_short Dimensions of psychosis in delirious and catatonic trauma critically Ill patients
title_sort dimensions of psychosis in delirious and catatonic trauma critically ill patients
topic Delirium
Catatonia
Critical illness
Intensive care unit
Trauma
Psychosis
url http://www.sciencedirect.com/science/article/pii/S2666144625000103
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