Jørgensen P, Jensen J
Department A, Psychiatric Hospital in Aarhus, Risskov, Denmark.
Psychopathology. 1994;27(1-2):100-12. doi: 10.1159/000284854.
Delusional beliefs in first admitters with no organic disorder are studied. The study sample of 88 patients provides a representation of delusional beliefs in first admitters. A scale for dimensions of delusional beliefs is proposed and applied to the patient group. The scale includes dimensions of conviction, extension, systematization, probability, pressure and global state. Adequate interobserver agreement is achieved. The patients are distributed according to ICD-10 and DSM-III-R with schizophrenia as the most frequent diagnostic category. More than half of the patients are, however, diagnosed differently. It is obvious that many patients with schizophrenia and persistent delusional disorder are seriously dysfunctioning at their entry into hospital. In contrast patients with affective disorder and acute and transient psychotic disorder are, on the average, functioning reasonably well. Identical delusional themes appear in different diagnostic categories while the dimensional severity of delusional beliefs varies from one category to another. When assessed at admission patients with a discharge diagnosis of schizophrenia have delusional beliefs with a high degree of dimensional severity in contrast to patients with affective disorder. Delusional beliefs in patients with persistent delusional disorder seem more systematized and probable than those diagnosed differently. In interpreting the findings one has to remember that the presence and theme of delusional beliefs are in no way independent aspects of diagnostic category. Description of delusional dimensions may, however, be important for the conceptualization of delusional beliefs and a method to study psychotic decompensation and resolution. Later on the patients were followed in search of the predictive significance of a qualified assessment of delusional beliefs in contrast to syndromes when defined according to new classification systems.
对首次入院且无器质性疾病的患者的妄想信念进行了研究。88名患者的研究样本代表了首次入院患者的妄想信念情况。提出了一种妄想信念维度量表并应用于患者群体。该量表包括确信度、扩展度、系统化程度、可能性、压力和整体状态等维度。观察者间达成了充分的一致性。患者根据国际疾病分类第十版（ICD - 10）和精神疾病诊断与统计手册第三版修订本（DSM - III - R）进行分类，精神分裂症是最常见的诊断类别。然而，超过一半的患者被诊断为其他疾病。显然，许多精神分裂症和持续性妄想障碍患者在入院时功能严重受损。相比之下，情感障碍以及急性和短暂性精神病性障碍患者平均功能状况尚可。相同的妄想主题出现在不同的诊断类别中，而妄想信念的维度严重程度在不同类别之间有所差异。入院时评估发现，出院诊断为精神分裂症的患者与情感障碍患者相比，其妄想信念的维度严重程度较高。持续性妄想障碍患者的妄想信念似乎比其他诊断的患者更具系统性和可能性。在解释研究结果时，必须记住妄想信念的存在和主题绝不是诊断类别的独立方面。然而，妄想维度的描述对于妄想信念的概念化以及研究精神病性失代偿和缓解的方法可能很重要。后来对患者进行了随访，以探寻与根据新分类系统定义的综合征相比，对妄想信念进行定性评估的预测意义。
