Opjordsmoen S, Retterstøl N
Psychiatr Dev. 1985 Summer;3(2):187-204.
301 first-admitted hospitalized patients with paranoid psychoses have been studied by Retterstøl over a period of 5-18 years. Common Scandinavian diagnostic procedures were used. About 200 are still alive, and these subjects are at present being interviewed semistructurally by Opjordsmoen using a modification of SADS-L, and making a total follow-up period of 22-37 years. The diagnoses are confirmed according to ICD-9, RDC, DSM-III and some specific groups of delusional disorders (DD) operationalized by Winokur and Kendler. All interviews have been carried out non-blind to the diagnoses which will make a bias possible. However, in paranoid cases, it is an advantage for establishing contact and a conductive atmosphere to know something about the patient beforehand. Based upon our own experiences and reviewing the literature, we point to some important methodological aspects regarding follow-up studies in delusional persons. The suspiciousness, misinterpretation, dissimulation, rationalization and convincing argumentation seen in many paranoid cases, call for a skilled investigator and a clinical approach. However, operational criteria, new diagnostic concepts and standard procedures for follow-up interviewing and outcome assessments will make comparison for international readers easier.
雷特斯特尔对301例首次住院的偏执型精神病患者进行了为期5至18年的研究。采用了斯堪的纳维亚常见的诊断程序。约200名患者仍然健在，目前奥普约德斯门正在使用对情感障碍和精神分裂症系统评定量表（SADS-L）的一种改良方法对这些受试者进行半结构式访谈，总随访期为22至37年。诊断依据国际疾病分类第九版（ICD-9）、研究用诊断标准（RDC）、精神疾病诊断与统计手册第三版（DSM-III）以及由维诺克和肯德勒实施的一些特定妄想障碍（DD）组进行确认。所有访谈都是在知晓诊断结果的情况下进行的，这可能会导致偏差。然而，在偏执型病例中，事先了解一些关于患者的情况有助于建立联系并营造融洽的氛围。基于我们自己的经验并回顾文献，我们指出了关于妄想症患者随访研究的一些重要方法学方面的问题。在许多偏执型病例中所见的猜疑、误解、掩饰、合理化和令人信服的论证，需要一名经验丰富的研究者和临床方法。然而，操作标准、新的诊断概念以及随访访谈和结果评估的标准程序将使国际读者更容易进行比较。
