1 Mental Health Unit, Granada University Hospital, Granada, Spain.
2 Department of Psychiatry, Faculty of Medicine, Granada University Hospital Complex, University of Granada, Granada, Spain.
Can J Psychiatry. 2018 Jan;63(1):12-19. doi: 10.1177/0706743717706347. Epub 2017 Jun 8.
To contribute to a better differential clinical categorisation of delusional disorder (DD) versus schizophrenia (SZ) and to add and complete evidence from previous clinical studies of DD compared to schizophrenia.
A cross-sectional study using a clinical sample of 275 patients (132 patients with DD) was studied. Patients were consecutively attending public clinics located in urban and rural areas in both Andalusia and Catalonia (Spain). All participants met DSM-IV diagnostic criteria for either DD or SZ. Data were gathered on sociodemographics, illness duration, Barona-Index estimation of intelligence quotient (IQ), and global functioning, along with a thorough psychopathological assessment using the Positive and Negative Syndrome Scale (PANSS). Comparisons between both groups were calculated using χ, Student t, and multivariate analysis of covariance tests.
Patients with DD were older (mean [SD], 50.3 [14.6] years vs. 36.6 [11.1] years; t = 8.597; P ≤ 0.0001), were more frequently married (45.4% vs. 10.8%; χ = 38.569; P ≤ 0.0001), and had a higher mean estimated premorbid IQ (111.4 vs. 105.4; t = 2.609; P ≤ 0.01). On the other hand, SZ patients were predominantly male (71.4% vs. 48.9%; χ = 14.433; P ≤ 0.0001) and had greater work-related disability than DD patients (20.5% vs. 50.3%; χ = 19.564; P ≤ 0.001). Overall, the DD group showed a less severe PANSS psychopathology than SZ group. Thus, total mean (SD) PANSS scores for schizophrenia and delusional disorder, respectively, were 76.2 (22.4) versus 54.1 (18.4) ( t = -8.762; P ≤ 0.0001). Moreover, patients with DD showed a better global functioning than those with SZ (62.7 [13.2] vs. 51.9 [16.9]; F = 44.114; P ≤ 0.0001).
DD is a milder and distinct disorder compared to SZ in terms of psychopathology and global functionality.
有助于对妄想障碍（DD）与精神分裂症（SZ）进行更好的临床鉴别分类，并补充和完善既往 DD 与 SZ 临床研究的证据。
采用横断面研究方法，对 275 例患者（DD 患者 132 例）进行研究。患者连续就诊于安达卢西亚和加泰罗尼亚（西班牙）城乡地区的公立诊所。所有参与者均符合 DSM-IV 对 DD 或 SZ 的诊断标准。采集社会人口学资料、疾病持续时间、Barona 指数估计智商（IQ）和总体功能，以及使用阳性和阴性综合征量表（PANSS）进行全面的精神病学评估。使用 χ、Student t 和协方差分析检验比较两组之间的差异。
DD 患者年龄较大（平均[标准差]，50.3[14.6]岁 vs. 36.6[11.1]岁；t = 8.597；P ≤ 0.0001），已婚比例较高（45.4% vs. 10.8%；χ=38.569；P ≤ 0.0001），预估的病前 IQ 平均值较高（111.4 比 105.4；t = 2.609；P ≤ 0.01）。另一方面，SZ 患者以男性为主（71.4% vs. 48.9%；χ=14.433；P ≤ 0.0001），与 DD 患者相比，工作相关残疾的比例更高（20.5% vs. 50.3%；χ=19.564；P ≤ 0.001）。总体而言，DD 组的 PANSS 精神病学症状比 SZ 组轻。因此，精神分裂症和妄想障碍的总平均（标准差）PANSS 评分分别为 76.2（22.4）和 54.1（18.4）（t=-8.762；P ≤ 0.0001）。此外，DD 患者的总体功能优于 SZ 患者（62.7[13.2]比 51.9[16.9]；F=44.114；P ≤ 0.0001）。
DD 在精神病学症状和总体功能方面与 SZ 相比是一种较轻且独特的疾病。
