Patients with delusions in a community psychiatric service. A follow-up study

Case records of 546 patients referred for the first time to a community psychiatric service were studied. Fifty-six patients revealed delusions of various types. The female/male ratio was 2:1, and the mean age 57 years. The majority of the paranoid patients belonged to the lowest socio-economic groups. Symptomatology, including type of delusion, treatment given and diagnostic classification is presented. The delusions occurred as part of all major psychotic syndromes with a preponderance of organic and affective psychoses. After 5-20 years of observation a full remission without relapse was seen in only 5%. However, the predictive value of delusions has not been sufficiently established, and the need for prospective studies of course and prognosis of psychoses with delusions is stressed.