Jørgensen P, Jensen J
Department A, Psychiatric Hospital in Aarhus, Risskov, Denmark.
Psychopathology. 1994;27(1-2):73-8. doi: 10.1159/000284851.
The persistence of delusional beliefs may to a marked degree influence the patients' global functioning. It is therefore clinically relevant to search for predictors of this course. In a study sample of 75 delusional first admitters such demographic, social and clinical variables were investigated which concern the course during 8 years. A number of variables had predictive value, e.g. characteristics of the delusional beliefs themselves such as theme and dimensions, absence of mood disturbance and subjective thought disorder but not hallucinations. The variables of diagnosis (schizophrenia according to the ICD-10 or the DSM-III-R at discharge from first admission) was a highly significant predictor of which only the following variables had a significant and independent predictive value: living alone, no psychosocial stressor, main delusion of persecution, and main delusion other than reference. In spite of the diagnostic uncertainty among first admitters the new systems of classification provide diagnostic categories as the most significant predictor of persistent delusional beliefs. Two logistic regression models for prediction are presented. In the presence of all independent predictors, the persistence of delusional beliefs is predicted for 94% of the present patient sample.
妄想信念的持续存在可能在很大程度上影响患者的整体功能。因此，寻找这一病程的预测因素具有临床相关性。在一个由75名首次入院的妄想症患者组成的研究样本中，对一些人口统计学、社会和临床变量进行了调查，这些变量涉及8年期间的病程。一些变量具有预测价值，例如妄想信念本身的特征，如主题和维度、无情绪障碍和主观思维障碍，但不包括幻觉。诊断变量（首次入院出院时根据ICD - 10或DSM - III - R诊断为精神分裂症）是一个高度显著的预测因素，只有以下变量具有显著且独立的预测价值：独居、无心理社会应激源、主要迫害妄想以及除关系妄想之外的主要妄想。尽管首次入院患者存在诊断不确定性，但新的分类系统提供的诊断类别是持续性妄想信念最显著的预测因素。文中给出了两个用于预测的逻辑回归模型。在所有独立预测因素都存在的情况下，对于当前患者样本中94%的患者可预测出妄想信念的持续性。
