Foulds G A, Bedford A, Csapo K G
Br J Psychiatry. 1975 Oct;127:316-9. doi: 10.1192/bjp.127.4.316.
Sixty-eight psychiatric in-patients who had completed the Delusions-Symptoms-States Inventory (D.S.S.I.) on admission were retested after one month. On first testing 92.6 per cent conformed to the hierarchy of classes of personal illness model, and on the second occasion 91.2 per cent. Of those who could improve, 72 per cent did so, most commonly by moving down one hierarchy class, e.g. from the Neurotic Symptoms class to the Dysthymic States class. (On the other hand only 30 per cent of the 61 patients who originally reported symptoms did not do so after one month.) Thus although it is clear that the patients as a group changed markedly, they have not departed from the hierarchy. These results indicate that either the symptoms further up the hierarchy remit before those lower in the hierarchy or they remit together. Certainly those lower in the hierarchy do not go first. It is suggested that the results would be difficult to accommodate within strict disease-entity models, and that they have different implications for both treatment and the assessment of change in current state.
68名入院时完成了妄想-症状-状态量表（D.S.S.I.）的精神科住院患者在一个月后进行了重新测试。首次测试时，92.6%的患者符合个人疾病模型的类别层次，第二次测试时为91.2%。在那些病情可能改善的患者中，72%的人确实得到了改善，最常见的是下降一个层次类别，例如从神经症症状类别降至心境恶劣状态类别。（另一方面，最初报告有症状的61名患者中，只有30%在一个月后没有改善。）因此，虽然很明显患者群体发生了显著变化，但他们并未偏离层次结构。这些结果表明，层次结构中较高位置的症状要么在较低位置的症状缓解之前就已缓解，要么它们一起缓解。当然，层次结构中较低位置的症状不会先缓解。有人认为，这些结果很难在严格的疾病实体模型中得到解释，而且它们对治疗和当前状态变化的评估都有不同的影响。
