Jørgensen P, Aagaard J
Department A, Psychiatric Hospital, Aarhus, Denmark.
Acta Psychiatr Scand. 1988 Mar;77(3):332-7. doi: 10.1111/j.1600-0447.1988.tb05130.x.
The purpose of the study was to examine whether clinical variables of first-admitted patients with delusional psychosis were of predictive importance of course and outcome illuminated through the dimensions: psychotic symptoms, impairment, remission, and relapse at 2-year follow-up. Male, sex, age below 30 years, unmarried, long duration of psychosis, and absence of psychosocial stress prior to first admission were all statistically predictive of poor outcome. Concerning nonspecific psychological distress high mean values on the subscales of helplessness-hopelessness, dread and antisocial history were correlated to poor outcome as was low mean value of active expression of hostility. Concerning psychopathology assessed by PSE individual items as lost emotions, thought insertion, thought broadcast, primary delusions and certain auditory hallucinations (voices discussing/commenting subject in third person) predicted poor outcome. Further classes of PSE symptoms as perceptual disorder, thought disorder, and delusions of influence predicted poor outcome too. Other prognostic unfavourable variables were systematisation of delusions, severe preoccupation with present delusions and no suspicion of attempt at concealment of delusions and hallucinations.
精神病性症状、功能损害、缓解情况以及2年随访时的复发情况。男性、年龄低于30岁、未婚、精神病病程长以及首次入院前不存在心理社会应激在统计学上均预示结局不良。关于非特异性心理困扰，无助-绝望、恐惧分量表上的高均值以及反社会史与结局不良相关，敌意主动表达的低均值也与结局不良相关。关于通过PSE评估的精神病理学，诸如情感缺失、思维插入、思维播散、原发性妄想以及某些幻听（以第三人称讨论/评论主体的声音）等个别条目预示结局不良。PSE症状的其他类别，如感知障碍、思维障碍以及被影响妄想也预示结局不良。其他预后不良变量包括妄想的系统化、对当前妄想的严重专注以及不怀疑存在对妄想和幻觉的隐瞒企图。
