Writing Disturbances: An Indicator for Postoperative Delirium

Abstract

Objective:To study the writing ability pre- and postoperatively in patients undergoing major surgery.Method:In an open study twenty-four consecutive patients undergoing thoracotomy for pulmonary malignancy were monitored for postoperative delirium throughout their stay in the hospital. The writing ability was tested on a preoperative day and on the third day after the operation. Main outcome measures were delirium according to the DSM-III-R criteria and writing ability assessed on items such as reluctance to write and motor-, spatial-, syntactical- and spelling disorders.Results:Five patients (21%) developed delirium according to the DSM-III-R criteria. The writing of all patients with delirium was severely impaired with features like reluctance to write, motor disability and spatial disturbances. No patient without delirium developed these disturbances.Conclusions:These results suggest that testing of writing ability may be useful in the diagnosis of delirium. The Delirium Writing Test is proposed as a diagnostic tool.