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Review
. 2022 Dec;16(12):1345-1352.
doi: 10.1111/eip.13283. Epub 2022 Mar 26.

The cognitive-phenomenological assessment of delusions and hallucinations at the early intervention in psychosis service stage: The results of a quality improvement project

Maria Isaacson  1   2 , Cassie M Hazell  3 , John Cape  1 , Emily Hickson  2 , Faaizah Islam  2 , Amber Gill  2 , Kathleen Simon  2 , Ruchit Patel  2 , Jonathan Souray  2 , David Raune  2
Affiliations
Review

The cognitive-phenomenological assessment of delusions and hallucinations at the early intervention in psychosis service stage: The results of a quality improvement project

Maria Isaacson et al. Early Interv Psychiatry. 2022 Dec.

Abstract

Aim: Clinical assessments are vital for gaining an understanding of a patients' presenting problem. A priority for Early Intervention in Psychosis Service staff is understanding and supporting their patients' experiences of hallucinations and/or delusions. We aimed to identify what cognitive-phenomenology dimensions of hallucinations and delusions EIPS staff were assessing with their patients.

Methods: We developed a brief checklist of cognitive-phenomenological dimensions of hallucinations and delusions called the Lived Experience Symptom Survey (LESS) based on relevant literature. As part of a Quality Improvement Project, we reviewed the health records of a sub-sample of EIPS patients using the LESS identifying whether each dimension was present or absent.

Results: We found that all patients had been asked about the content of their hallucinations and/or delusions, and the majority had been asked about the valence of this content. Despite patients having experienced psychosis for almost 2 years on average, less than half of patients were asked about the potential or actual harm associated with these symptoms. All other cognitive-phenomenological dimensions were assessed inconsistently.

Conclusions: The assessment of hallucination and delusions in our EIPS was inconsistent and incomprehensive. These findings require replication in other EIPS' but may point to a need for guidelines and training around how to conduct a thorough assessment of hallucinations and delusions for current and future EIPS staff. Improved assessment of these symptoms will aid the development of risk assessments and treatment plans.

Keywords: delusions; hallucinations; psychiatry; psychotic disorders; quality improvement.

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References

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