[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-449051-105":59,"doc-detail-449051-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","diagnose-pediatric-delirium-preferentially-by-psychiatric-examination-as-capd-has-low-specificity","Diagnose Pediatric Delirium Preferentially by Psychiatric Examination, as CAPD Has Low Specificity","","Letter to the editor responding to a cross-sectional study on delirium prevalence and risk factors in a pediatric intensive care unit. The authors argue that delirium diagnosis relied on CAPD rather than comprehensive psychiatric examinations and note CAPD’s low specificity. They request more detailed causes of delirium, clearer differential diagnoses, specification of PICU admission reasons, and description of therapeutic measures. They conclude delirium diagnosis requires psychiatric assessment, instrumental testing, and exclusion of alternative diagnoses.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diagnose-pediatric-delirium-preferentially-by-psychiatric-examination-as-capd-has-low-specificity/449051/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diagnose-pediatric-delirium-preferentially-by-psychiatric-examination-as-capd-has-low-specificity/449051.png","ImageObject",300,407,{"name":92,"@type":93},"Stanley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why do the authors question the use of CAPD for diagnosing pediatric delirium?","Question",{"text":112,"@type":113},"They state that CAPD is based on observations without required patient interaction, repeated results can vary, it is time-consuming, and its specificity is low (45–79%).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What diagnostic method do the authors recommend instead?",{"text":117,"@type":113},"They recommend a comprehensive psychiatric examination using DSM-based criteria, including the confusion assessment method (CAM), described as a gold-standard, widely used bedside tool.",{"name":119,"@type":110,"acceptedAnswer":120},"What additional details do the authors ask for regarding delirium in the study cohort?",{"text":121,"@type":113},"They request the detailed underlying causes, ruling out differential diagnoses, the specific reason for PICU admission, and a description of treatment measures, including whether delirium was temporary or persistent.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449051,1790815310,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","LETTER TO THE EDITOR  \nDiagnose Pediatric Delirium Preferentially by Psychiatric Examination, as CAPD Has Low Specificity  \nCarla A Scorza1, Fulvio A Scorza2, Josef Finsterer3  \nKeywords: Cornell assessment of pediatric delirium, Delirium, Pediatric intensive care unit, Psychiatry, Specificity.  \nIndian Journal of Critical Care Medicine (2025): 10.5005/jp-journals-10071-25088  \nDear Editor,  \nWe read with interest the article by Nashit et al. on a cross-sectional study of the prevalence and risk factors of delirium, which was diagnosed using the Cornell assessment of pediatric delirium (CAPD) in 201 patients aged 1 month–14 years admitted to a pediatric intensive care unit (PICU) in Karachi.1 The frequency of delirium in the cohort studied was 25%, and the risk factors for the occurrence of delirium were comorbidities, developmental delays, medications (e.g., benzodiazepines, antiepileptics), high-flow oxygen, and mechanical ventilation.1 The study is interesting, but some points need to be discussed.  \nThe first point is that delirium was diagnosed using CAPD, not psychiatric examinations. Cornell assessment of pediatric delirium has several disadvantages. Its results are based on observations, and performing the test does not require interaction with the patient. Repeated test results can vary greatly, and performing the testis time-consuming. In addition, the specificity of the test is low, ranging from 45 to 79% with a cutoff value of 9.2 Delirium should be diagnosed through a comprehensive psychiatric examination based on criteria from the diagnostic and statistical manual of mental (DSM), such as the confusion assessment method (CAM), which is considered the gold standard for diagnosing delirium.3 The CAM is a structured tool derived from these criteria and is considered the most widely used and effective tool for diagnosing delirium at the bedside.  \nThe second point is that the causes of delirium in the cohort studied were not specified in detail.1 Causes of delirium include not only medications, but also infections (e.g., urinary tract infections, pneumonia), endocrine disorders (e.g., diabetes, thyroid dysfunction), pain, surgery, sleep deprivation, electrolyte imbalances, dehydration, intoxication, and substance withdrawal.4 Knowledge of the underlying cause of delirium is crucial for optimal treatment of the condition.  \nThe third point is that differential diagnoses of delirium have not been sufficiently ruled out.1 Differential diagnoses of delirium include psychosis, dementia, depression, systemic infections, metabolic disorders, systemic diseases, and many neurological diseases. In order to rule out all of these conditions, not only psychiatric examinations but also comprehensive clinical and instrumental examinations must be performed. The instrumental examinations required for the diagnosis of delirium include comprehensive blood tests, cerebral imaging using magnetic resonance imaging, magnetic resonance angiography, electroencephalography, and, if necessary, cerebrospinal fluid examinations, magnetic resonance spectroscopy, and positron emission tomography.  \n1,2Federal University of Sao Paulo (UNIFESP/EPM), São Paulo, Brazil 3Department of Neurology, Neurology and Neurophysiology Center, Vienna, Austria  \nCorresponding Author: Josef Finsterer, Department of Neurology, Neurology and Neurophysiology Center, Vienna, Austria, Phone: + 43  \n15861075, [e-mail: fifigs1@yahoo.de](e-mail: fifigs1@yahoo.de)  \nHow to cite this article: Scorza CA, Scorza FA, Finsterer J. Diagnose Pediatric Delirium Preferentially by Psychiatric Examination, as CAPD Has Low Specificity. Indian J Crit Care Med 2025;29(12):1061–1062 . Source of support: Nil  \nConflict of interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.  \nThe fourth point is that the reason for admission tothe PICU was not specified in deta","cbCainH71qZ7CeL2","https://ap.wps.com/l/cbCainH71qZ7CeL2","pdf",215305,"English","# Letter to the Editor\n## Diagnosis approach and CAPD specificity\n## Need for detailed causes\n## Differential diagnoses to be ruled out\n## Clarify reason for PICU admission\n## Treatment measures for delirium\n## Summary and concluding remarks","[{\"question\":\"Why do the authors question the use of CAPD for diagnosing pediatric delirium?\",\"answer\":\"They state that CAPD is based on observations without required patient interaction, repeated results can vary, it is time-consuming, and its specificity is low (45–79%).\"},{\"question\":\"What diagnostic method do the authors recommend instead?\",\"answer\":\"They recommend a comprehensive psychiatric examination using DSM-based criteria, including the confusion assessment method (CAM), described as a gold-standard, widely used bedside tool.\"},{\"question\":\"What additional details do the authors ask for regarding delirium in the study cohort?\",\"answer\":\"They request the detailed underlying causes, ruling out differential diagnoses, the specific reason for PICU admission, and a description of treatment measures, including whether delirium was temporary or persistent.\"}]","Diagnose Pediatric Delirium Preferentially by Psychiatric Examination, as CAPD Has Low Specificity | PDF",1790729278]