Kennedy H G, Kemp L I, Dyer D E
Maudsley Hospital, London.
Br J Psychiatry. 1992 Apr;160:488-92. doi: 10.1192/bjp.160.4.488.
We report a series of 15 patients with delusional (paranoid) disorder as defined in DSM-III-R. All were supervised by a forensic psychiatry service after violent or threatening acts. We hypothesised that delusions and actions in these patients would be congruent with an abnormal mood characterised by fear and anger. Informants and the patients indicated a pervasive and persistent abnormality of mood (fear and defensive anger), with delusions and actions that were congruent with this mood during the offence and for over a month before. Other behaviours, such as fleeing or barricading to avoid delusional persecutors, were also consistent with congruence of mood and delusions. In all cases, violent acts and mood were congruent, but in three cases the violent act was unrelated to delusions. Although a study such as this does not demonstrate that the mood abnormality is primary, we believe moods of fear and anger in delusional disorder are not sufficiently recognised as part of the disorder.
我们报告了一系列符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中定义的15例妄想（偏执）障碍患者。所有患者在实施暴力或威胁行为后均由法医精神病服务机构监管。我们假设这些患者的妄想和行为与以恐惧和愤怒为特征的异常情绪相一致。 informant和患者均表示存在普遍且持续的情绪异常（恐惧和防御性愤怒），在犯罪期间及之前一个多月，其妄想和行为与这种情绪相一致。其他行为，如为躲避妄想中的迫害者而逃跑或设置障碍，也与情绪和妄想的一致性相符。在所有案例中，暴力行为与情绪均相符，但有3例暴力行为与妄想无关。尽管这样的研究并未证明情绪异常是原发性的，但我们认为妄想障碍中恐惧和愤怒的情绪未被充分认识到是该障碍的一部分。
