Functional and clinical outcomes of delusional disorder and schizophrenia patients after first episode psychosis: a 4-year follow-up study

BMC Psychiatry

Research

Christy Lai Ming Hui¹  Evie Wai Ting Chan¹  Sally Hiu Wah See¹  Edwin Ho Ming Lee¹  Priscilla Wing Man Hui¹  Yi Nam Suen¹  Tiffany Junchen Tao¹  Bertha Sze Ting Lam¹  Elise Chun Ning Ho¹  Sherry Kit Wa²  Wing Chung Chang²  Eric Yu Hai Chen² 

[1] Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong;Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong;State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, Hong Kong;

关键词: Schizophrenia;    Paranoid schizophrenia;    Psychotic disorders;    Psychopathology;    Psychosocial functioning;   

DOI  :  10.1186/s12888-023-05175-z

 received in 2023-05-11, accepted in 2023-09-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLiterature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the differential age of onset. This study therefore aims to investigate the diagnostic stability, clinical, functional, and neurocognitive differences of Chinese first-episode psychosis age-matched patients with delusional disorder and schizophrenia at four years.Methods71 delusional disorder and 71 age-matched schizophrenia patients were followed up for four years after their initial episode. Their symptoms, insight in psychosis, side effects of medication, medication compliance, functioning, and neurocognitive performance were assessed at four years.ResultsAt four years, 65% of DD patients maintained the same diagnosis, while the rest shifted to SZ. Only those without a diagnostic shift were included in the analysis. Delusional disorder patients (n = 46) experienced greater general psychopathology and poorer insight, but better attitude towards medication than schizophrenia patients (n = 71). Social and occupational functioning, quality of life, and cognitive functioning, however, were similar in delusional disorder and schizophrenia patients.ConclusionsResults indicate that delusional disorder is less diagnostically stable than schizophrenia. Their outcomes in a Chinese population were largely similar at four years after removing the confounding age factor, implying that delusional disorder and schizophrenia may not be as distinct as previously thought.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1