Contrasting Monosymptomatic Patients with Hallucinations and Delusions in First-Episode Psychosis Patients: A Five-Year Longitudinal Follow-Up Study

Abstract

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. Key WordsHallucinations ؒ Delusions ؒ Psychotic symptoms ؒ Suicide Abstract 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,

Auditory and non-auditory hallucinations in first-episode psychosis: Differential associations with diverse clinical features

“…Our analysis showed that both Auditory Hallucinations score and Non-Auditory Hallucinations score were related to BIS total score. This result is in line with previous studies, though they compared patients with hallucinations only or with delusions only, and with both hallucinations and delusions or with neither of them (Evensen et al, 2011; Engh et al, 2010;). However, the first study involved only 16 first-episode psychosis patients experiencing hallucinations, and insight was measured only with the individual PANSS lack of judgment/insight item, and the second study relied on a sample with chronic psychotic disorders and used the Beck Cognitive Insight Scale.…”

“…Regarding sociodemographic characteristics, female first-episode patients had a higher score for visual and auditory hallucinations than their male counterparts (Thorup et al, 2007), and patients with a positive family history of psychosis were more likely to have tactile hallucinations (Uçok and Bikmaz, 2007). Pertaining to clinical features, Evensen et al (2011) reported better cognitive insight in first-episode patients with hallucinations only compared to patients with delusions only.…”

Which Aspects of Long-Term Outcome Are Predicted by Positive and Negative Symptoms in Early-Onset Psychosis? An Exploratory Eight-Year Follow-Up Study

“…Specific significance of hallucinations and delusions for diagnostic stability and illness course was observed in adults [11,20]. In our study hallucinations and suspiciousness were associated with further treatment but were not specific for schizophrenia diagnosis.…”

Psykisk syke mangler rettssikkerhet

“…En høy grad av sykdomsinnsikt ser ut til å øke risikoen gjennom faktorer som negative antagelser om egen lidelse (liten tro på tilfriskning og at lidelsen kan kontrolleres) og negative tanker (håpløshet) når det gjelder framtiden (44;45). Et symptombilde preget av hallusinasjoner ser også ut til å innebaere høyere selvmordsrisiko (153), se kapittel 7 om utredning av selvmordsrisiko.…”