Fear C, Sharp H, Healy D
Kidderminster General Hospital, Worcestershire.
Br J Psychiatry. 1996 Jan;168(1):61-7. doi: 10.1192/bjp.168.1.61.
Studies of schizophrenics with persecutory delusions have shown cognitive biases in subjects who are deluded. It has been suggested that their delusions defend against depression. This study challenges the assumption that delusional disorder (DD) patients are covertly depressed.
Clinical and demographic data, and responses to questionnaires designed to assess schizotypy, depression, dysfunctional attitudes, attributional and attention biases were collected from 29 patients satisfying DSM-III-R criteria for DD. These were compared with 20 matched normal controls and results from published studies of schizophrenics.
DD subjects did not show abnormal levels of overt or covert depression or schizotypy. They showed high levels of dysfunctional attitudes (P < 0.0001), a distinctive attributional style (P = 0.01), and increased attention to threat-related stimuli (P = 0.01).
DD is a distinct disorder predicated upon sensitivity to threat and biases of attention and attribution. These findings may have implications for the cognitive therapy of these disorders.
对患有被害妄想症的精神分裂症患者的研究表明，妄想症患者存在认知偏差。有人认为他们的妄想是为了抵御抑郁。本研究对妄想障碍（DD）患者存在隐性抑郁这一假设提出了质疑。
收集了29名符合DSM-III-R标准的DD患者的临床和人口统计学数据，以及他们对旨在评估精神分裂症型人格、抑郁、功能失调性态度、归因和注意偏差的问卷的回答。将这些数据与20名匹配的正常对照以及已发表的精神分裂症患者研究结果进行比较。
DD患者未表现出明显或隐性抑郁或精神分裂症型人格的异常水平。他们表现出高水平的功能失调性态度（P < 0.0001）、独特的归因风格（P = 0.01），以及对威胁相关刺激的关注度增加（P = 0.01）。
DD是一种基于对威胁的敏感性以及注意和归因偏差的独特障碍。这些发现可能对这些障碍的认知治疗具有启示意义。
