A multivariate predictor analysis of course and outcome in delusional psychosis.

Abstract

The purpose of the study was to examine whether certain social variables of first-admitted patients with delusional psychosis were of predictive value of course and outcome as illuminated through the dimensions: psychiatric symptoms, impairment, remission, and relapse at 2-year follow-up. Furthermore, the aim was to perform a multivariate analysis of the most informative clinical and social predictors of course and outcome. Several predictors were significantly associated with at least one of the dimensions of poor outcome. In the multivariate logistic analysis an independent significant effect was assigned to male sex, no work, no evasiveness of delusions, perceptual disorder, preoccupation with delusions, dread, and few social contacts. The most informative clinical and social predictors yielded a maximal information of 27% to 47% for the different dimensions of course and outcome. One fifth of the patients had good outcome. This was significantly predicted by the following variables: married, living with others, frequent social contacts, high social group, full time work, clouding, delusions of guilt, and attempt at concealment of delusions and hallucinations, yielding a maximal information of 41%. Frequent social contacts and delusions of guilt had an independent statistical effect on good outcome. It is concluded that good prognosis is exceptional in patients with delusional psychosis and not combined to a single nosological unit. The findings stress the need for a specific investigation of the prognostic importance of social intervention and community care in patients with delusional psychosis.