Rapid, efficient and accurate diagnosis of clinical subtype in patients with delirium
Introduction
Welcome to the DMSS site which provides information on the delirium motor subtyping scale (dmss) and its brief version, the DMSS-4.
These scales can be used for rapid and efficient diagnosis of clinically meaningful subtypes of delirium
You can also find up to date Information on the development and validation of the scale as well as the various language versions that are available for use in diagnosing the clinical subtypes of delirium for both clinical and research studies
All versions of the DMSS are free to use but please contact the authors at: david.meagher@ul.ie where we will delighted to discuss any queries you have about its use
Motor subtyping for delirium
Disturbances of motor activity levels are extremely common in delirium (almost invariably present) and consist of two contrasting patterns – hypoactivity (retardation) versus hyperactivity (hypervigilance / agitation). A significant number of patients experience both patterns within short time frames and are designated as ‘mixed’ subtype.
The assessment of clinical subtypes based on motor activity profile holds considerable promise for delirium research. Studies suggest that these subtypes significantly differ in relation to a range of clinical parameters including pathophysiology, treatment response and prognosis.
The original DMSS (Meagher et al, 2008) is an 11-item scale derived from relevant elements of previous subtyping schemes. It has established concurrent and predictive validity (Godfrey et al, 2010) and has been revalidated in other delirious populations (Mattoo et al, 2012)
Recent work has reduced the DMSS to a simpler and ultra-rapid 4-item scale which correlates highly with the original full scale (Meagher et al, 2014) and which has high inter-rater reliability between doctors, nurses and medical students (Fitzgerald et al, 2016)
The DMSS can be used by any healthcare professional who is familiar with assessment of patients with delirium. To date, it has been used in studies of patients in a variety of settings - general medical, palliative care, CL Psychiatry referrals and post-operative patients. It has been used in a variety of countries and languages, including Ireland, Holland, India, Spain, Japan, Korea and Germany.
A list of relevant publications is provided on the Publications page (click on link above).
