Jørgensen P
Department A, Psychiatric Hospital in Aarhus, Risskov, Denmark.
Psychopathology. 1994;27(1-2):89-99. doi: 10.1159/000284853.
A group of 88 delusional patients has been followed prospectively from first admission. The 2-, 4-, and 8-year course and outcome for 75 patients still alive are presented according to main delusional theme at index admission and from a dimensional approach. From the time of index admission, the groups of patients differ with respect to preceding course and global functioning. In general, these differences are maintained although some become more pronounced. The most optimistic perspective appears for patients with main delusion of reference or a low dimensional severity of delusional beliefs and the most pessimistic for patients with main delusions of persecution or influence and for those with a high dimensional severity of delusional beliefs. Thirty-two patients remained delusional throughout the observation period, in most cases with unchanged thematic content; 57% had an episodic and 43% a chronic course. When distributed according to main delusional theme at index admission, Global Assessment Functioning at 8-year follow-up is: persecution, 43; reference, 69; influence, 34; guilt, 58; others, 55; and, on average, 52. Only minor changes occurred between the three follow-up investigations. After the 8-year observation period, more than 50% of the patients were diagnosed schizophrenia. During the observation period 5 patients committed suicide, which means that delusional first admitters have a risk of suicide which is 31.5 times greater than in the general population. The dimensional severity of delusional beliefs is of importance when course and outcome are concerned and may be complementary to a traditional description.
一组88名妄想症患者从首次入院起就接受了前瞻性跟踪。根据首次入院时的主要妄想主题，并采用维度分析法，呈现了75名仍在世患者的2年、4年和8年病程及转归情况。从首次入院时起，这些患者组在之前的病程和整体功能方面存在差异。总体而言，这些差异一直存在，尽管有些差异变得更加明显。对于主要存在被洞悉妄想或妄想信念维度严重程度较低的患者，前景最为乐观；而对于主要存在被害妄想或被控制感妄想以及妄想信念维度严重程度较高的患者，前景最为悲观。在整个观察期内，32名患者一直存在妄想，在大多数情况下，妄想主题内容未变；57%的患者病程呈发作性，43%呈慢性。按照首次入院时的主要妄想主题进行分类，8年随访时的总体功能评估结果为：被害妄想，43；被洞悉妄想，69；被控制感妄想，34；罪恶妄想，58；其他，55；平均为52。三次随访调查之间仅有微小变化。经过8年观察期后，超过50%的患者被诊断为精神分裂症。在观察期内，有5名患者自杀，这意味着首次因妄想入院的患者自杀风险比普通人群高31.5倍。当涉及病程和转归时，妄想信念的维度严重程度很重要，并且可能是对传统描述的补充。
