Grunfeld Gil, Lemonde Ann-Catherine, Gold Ian, Iyer Srividya N, Malla Ashok, Lepage Martin, Joober Ridha, Boksa Patricia, Shah Jai L
Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montréal, QC, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2023 Jan;58(1):35-41. doi: 10.1007/s00127-022-02324-9. Epub 2022 Jul 30.
While the prevalence of delusional themes appears to be consistent across geographic contexts, little is known about the relative prevalence of such themes within a given setting over periods of time. We therefore investigated delusional themes across 12 years of presentation to a catchment-based early intervention service for first episode psychosis (FEP).
Systematically collected data from 500 patients at an early intervention service for FEP were analyzed. Four cohorts of 3 years each, from 2006 to 2017, were used to compare the frequency of delusion themes across cohorts. We also integrated into the analysis baseline sociodemographic factors such as gender, age, and highest level of education and clinical factors such as anxiety, depression, suicidality, hallucinations, and primary diagnosis (affective or non-affective psychosis).
Sex and education level were stable across cohorts, while patient age varied (p = 0.047). Clinical anxiety, depression, and suicidality at entry were also stable. Across cohorts, the proportion of patients with affective versus non-affective diagnosis differed (p = 0.050), with no differences in global rating of delusion severity or theme prevalence except for delusions of guilt or sin (p = 0.001). This single theme difference was not correlated with age or diagnosis.
Our study suggests relatively stable prevalence of delusion themes across cohorts of individuals experiencing FEP. This demonstrates the potential utility of studying thematic content both for understanding delusions in clinical populations and in research. Future explorations of the relationships between delusion themes and across individual patient episodes should be conducted.
虽然妄想主题的患病率在不同地理环境中似乎是一致的，但对于在特定环境中一段时间内这些主题的相对患病率却知之甚少。因此，我们调查了在一个基于集水区的首发性精神病（FEP）早期干预服务机构就诊12年间的妄想主题。
对来自FEP早期干预服务机构的500名患者的系统收集数据进行分析。使用了从2006年到2017年每3年一组的四个队列，来比较各队列中妄想主题的频率。我们还将基线社会人口学因素（如性别、年龄和最高教育水平）以及临床因素（如焦虑、抑郁、自杀倾向、幻觉和主要诊断（情感性或非情感性精神病））纳入分析。
各队列中的性别和教育水平稳定，而患者年龄有所不同（p = 0.047）。入院时的临床焦虑、抑郁和自杀倾向也稳定。各队列中，情感性与非情感性诊断的患者比例不同（p = 0.050），除了罪恶妄想（p = 0.001）外，妄想严重程度的总体评分或主题患病率没有差异。这一单一主题差异与年龄或诊断无关。
我们的研究表明，在经历FEP的个体队列中，妄想主题的患病率相对稳定。这表明研究主题内容对于理解临床人群中的妄想以及研究都具有潜在的实用性。未来应探索妄想主题与个体患者发作之间的关系。
