Clinical predictors of course and outcome in delusional psychosis

The purpose of the study was to examine whether clinical variables of first-admitted patients with delusional psychosis were of predictive importance of course and outcome illuminated through the dimensions: psychotic symptoms, impairment, remission, and relapse at 2-year follow-up. Male, sex, age below 30 years, unmarried, long duration of psychosis, and absence of psychosocial stress prior to first admission were all statistically predictive of poor outcome. Concerning nonspecific psychological distress high mean values on the subscales of helplessness-hopelessness, dread and antisocial history were correlated to poor outcome as was low mean value of active expression of hostility. Concerning psychopathology assessed by PSE individual items as lost emotions, thought insertion, thought broadcast, primary delusions and certain auditory hallucinations (voices discussing/commenting subject in third person) predicted poor outcome. Further classes of PSE symptoms as perceptual disorder, thought disorder, and delusions of influence predicted poor outcome too. Other prognostic unfavourable variables were systematisation of delusions, severe preoccupation with present delusions and no suspicion of attempt at concealment of delusions and hallucinations.