Contrasting monosymptomatic patients with hallucinations and delusions in first-episode psychosis patients: a five-year longitudinal follow-up study

TY - JOUR

T1 - Contrasting monosymptomatic patients with hallucinations and delusions in first-episode psychosis patients

T2 - a five-year longitudinal follow-up study

AU - Evensen, Julie

AU - Røssberg, Jan Ivar

AU - Haahr, Ulrik

AU - ten Velden Hegelstad, Wenche

AU - Joa, Inge

AU - Johannessen, Jan Olav

AU - Langeveld, Hans

AU - Larsen, Tor Ketil

AU - Melle, Ingrid

AU - Opjordsmoen, Stein

AU - Rund, Bjørn Rishovd

AU - Simonsen, Erik

AU - Sundet, Kjetil

AU - Vaglum, Per

AU - Friis, Svein

AU - McGlashan, Thomas

N1 - Copyright © 2011 S. Karger AG, Basel.

PY - 2011/1

Y1 - 2011/1

N2 - Background: The main aim of this study was to identify subgroups of patients characterized by having hallucinations only or delusions only and to examine whether these groups differed with regard to demographic characteristics, clinical characteristics and outcome factors, including suicidality. Methods: Out of 301 consecutively admitted patients with first-episode psychosis, individuals with delusions only (D) and hallucinations only (H) were identified based on Positive and Negative Syndrome Scale (PANSS) items P1 (delusions) and P3 (hallucinations) scores at baseline and through 4 follow-up interviews over 5 years. The subgroups were compared with regard to demographic data, premorbid functioning, duration of untreated psychosis, clinical variables, time to remission and suicidality. Results: Two groups of patients were identified; H (n = 16) and D (n = 106). 179 patients experienced both hallucinations and delusions (dual symptom group). The H group was significantly younger, had a longer duration of untreated psychosis, poorer premorbid function and better insight than the D group. Notably, the H group scored higher on measures of suicidality, and at 5 years follow-up a significantly higher proportion of patients was lost to suicide in this group. The dual symptom group was closer to the D group on significant parameters, including suicidality and suicide rate. Conclusions: Patients with hallucinations only can be separated from patients with delusions only and the subgroups differ with regard to demographical data, clinical variables and notably with regard to suicidality. These findings suggest distinctions in the underlying biological and psychological processes involved in hallucinations and in delusions.

AB - Background: The main aim of this study was to identify subgroups of patients characterized by having hallucinations only or delusions only and to examine whether these groups differed with regard to demographic characteristics, clinical characteristics and outcome factors, including suicidality. Methods: Out of 301 consecutively admitted patients with first-episode psychosis, individuals with delusions only (D) and hallucinations only (H) were identified based on Positive and Negative Syndrome Scale (PANSS) items P1 (delusions) and P3 (hallucinations) scores at baseline and through 4 follow-up interviews over 5 years. The subgroups were compared with regard to demographic data, premorbid functioning, duration of untreated psychosis, clinical variables, time to remission and suicidality. Results: Two groups of patients were identified; H (n = 16) and D (n = 106). 179 patients experienced both hallucinations and delusions (dual symptom group). The H group was significantly younger, had a longer duration of untreated psychosis, poorer premorbid function and better insight than the D group. Notably, the H group scored higher on measures of suicidality, and at 5 years follow-up a significantly higher proportion of patients was lost to suicide in this group. The dual symptom group was closer to the D group on significant parameters, including suicidality and suicide rate. Conclusions: Patients with hallucinations only can be separated from patients with delusions only and the subgroups differ with regard to demographical data, clinical variables and notably with regard to suicidality. These findings suggest distinctions in the underlying biological and psychological processes involved in hallucinations and in delusions.

KW - Adolescent

KW - Adult

KW - Aged

KW - Delusions

KW - Female

KW - Follow-Up Studies

KW - Hallucinations

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Psychotic Disorders

KW - Suicide

U2 - 10.1159/000319789

DO - 10.1159/000319789

M3 - Journal article

C2 - 21228615

SN - 0254-4962

VL - 44

SP - 90

EP - 97

JO - Psychopathology

JF - Psychopathology

IS - 2

ER -