Changes in delusional dimensions and emotions over eight weeks of antipsychotic treatment in acute patients

Delusional experiences can be considered on a range of dimensions including conviction, distress, preoccupation, and disruption, which have been shown to be related to depression and anxiety. This study aimed to test the hypotheses that delusional conviction is less responsive to antipsychotic treatment than delusional distress and preoccupation, and that depression and anxiety reduce alongside improvements in delusional dimensions. Forty acutely ill inpatients with delusions were assessed during their early stage of antipsychotic treatment. Interview data were analysed using mixed models for repeated measures. There was a significant reduction in psychotic symptoms over eight weeks, after controlling for baseline dosage of antipsychotics. We found no differential rate of improvement across delusional dimensions, and all dimensions improved over time. However, conviction ratings remained relatively high throughout the eight weeks. There was no significant improvement in anxiety and depression, and delusional preoccupation covaried with anxiety and depression throughout eight weeks, suggesting a relationship between emotional and delusional processes during the early recovery phase of psychosis.