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一般人群中的妄想:系统评价,重点关注方法学。

Delusions in the general population: A systematic review with emphasis on methodology.

机构信息

Mental Health Center Amager, Gl. Kongevej 33, 1610, Copenhagen V, Denmark.

Mental Health Center Amager, Gl. Kongevej 33, 1610, Copenhagen V, Denmark.

出版信息

Schizophr Res. 2020 Feb;216:48-55. doi: 10.1016/j.schres.2019.10.043. Epub 2019 Dec 10.

Abstract

The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and comprehension is a matter of continuing debate. In recent years studies showing that delusions are common in the general population have accumulated and challenged the way we perceive psychotic illness. In this systematic review, we examine the basis of the psychosis continuum-hypothesis, by reviewing a representative section of the original literature that report measures of delusional ideation in the general population, focusing specifically on methodology. Three online databases were systematically searched for relevant studies. After applying criteria of inclusion and exclusion, 17 articles were included for comprehensive review. Estimates of the distribution of delusions in the general population vary substantially, as does the mode of assessment. The methodology relies with few exceptions exclusively on self-report and fully structured interview by lay person. We conclude that measures of delusions in the general population should be interpreted cautiously due to inherent difficulties in methodology. Hypothesizing a continuum of delusion between normality and full-blown psychosis is deemed premature based on the reviewed studies.

摘要

妄想的存在被认为是精神病的一个关键特征,但尽管妄想的概念在精神病理学中具有核心地位,但对其定义和理解仍存在持续的争议。近年来,越来越多的研究表明,妄想在普通人群中很常见,这挑战了我们对精神病的看法。在这项系统综述中,我们通过回顾原始文献中报告普通人群妄想观念测量的代表性部分,专门关注方法论,来检验精神病连续性假说的基础。我们系统地搜索了三个在线数据库以寻找相关研究。在应用纳入和排除标准后,纳入了 17 篇文章进行全面审查。普通人群中妄想的分布估计差异很大,评估方式也不同。该方法除了极少数例外,完全依赖于非专业人员的自我报告和完全结构化访谈。我们的结论是,由于方法学上的固有困难,应谨慎解释普通人群中妄想的测量结果。根据已审查的研究,假设从正常到完全精神病之间存在妄想连续体还为时过早。

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