Jørgensen P
Department A, Psychiatric Hospital in Aarhus, Copenhagen.
Acta Psychiatr Scand. 1987 Sep;76(3):317-23. doi: 10.1111/j.1600-0447.1987.tb02901.x.
The purpose of the study was to examine first-admitted patients with delusional psychosis meaning functional psychosis with paranoid symptoms with respect to clinical course and outcome. The index population comprised 88 patients. At discharge from first admission the patients were classified according to ICD-8 and DSM-III. According to both diagnostic classifications the majority of the patients did not belong to either of the two major psychotic groups, schizophrenia or affective psychosis. During the 2-year observation period half of the patients took psychotropic drugs continuously, and almost half of the patients experienced one or more relapses. One third of the patients were readmitted, and in average the patients stayed in the hospital for 4 months during the observation period including the time of index admission. At follow-up half of the patients revealed positive psychotic symptoms, while two thirds were moderately or severely impaired because of psychotic illness or personality dysfunction. It is concluded that the present aftercare treatment is insufficient to prevent relapse and psychotic symptoms. In consequence of this the existence of delusions at first admission to hospital because of functional psychosis seems for many to predict an unfavourable course and outcome. Further study will search for clinical and social predictors of course and outcome in patients with delusional psychosis.
该研究的目的是针对首次收治的妄想性精神病患者（即伴有偏执症状的功能性精神病患者）的临床病程和预后进行研究。研究对象包括88名患者。首次入院出院时，根据国际疾病分类第八版（ICD - 8）和精神疾病诊断与统计手册第三版（DSM - III）对患者进行分类。根据这两种诊断分类，大多数患者不属于精神分裂症或情感性精神病这两大主要精神病群体。在2年的观察期内，一半的患者持续服用精神药物，近一半的患者经历了一次或多次复发。三分之一的患者再次入院，在观察期内（包括首次入院时间），患者平均住院4个月。随访时，一半的患者仍有阳性精神病症状，而三分之二的患者因精神病性疾病或人格功能障碍而有中度或重度损害。研究得出结论，目前的后续治疗不足以预防复发和精神病症状。因此，因功能性精神病首次入院时存在妄想似乎对许多患者而言预示着不良的病程和预后。进一步的研究将探寻妄想性精神病患者病程和预后的临床及社会预测因素。
