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. 2023 Sep 18;23(1):676.
doi: 10.1186/s12888-023-05175-z.

Functional and clinical outcomes of delusional disorder and schizophrenia patients after first episode psychosis: a 4-year follow-up study

Christy Lai Ming Hui  1 , Evie Wai Ting Chan  2 , Priscilla Wing Man Hui  2 , Tiffany Junchen Tao  2 , Elise Chun Ning Ho  2 , Bertha Sze Ting Lam  2 , Sally Hiu Wah See  2 , Yi Nam Suen  2 , Wing Chung Chang  2   3 , Sherry Kit Wa  2   3 , Edwin Ho Ming Lee  2 , Eric Yu Hai Chen  2   3
Affiliations

Functional and clinical outcomes of delusional disorder and schizophrenia patients after first episode psychosis: a 4-year follow-up study

Christy Lai Ming Hui et al. BMC Psychiatry. .

Abstract

Background: Literature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the differential age of onset. This study therefore aims to investigate the diagnostic stability, clinical, functional, and neurocognitive differences of Chinese first-episode psychosis age-matched patients with delusional disorder and schizophrenia at four years.

Methods: 71 delusional disorder and 71 age-matched schizophrenia patients were followed up for four years after their initial episode. Their symptoms, insight in psychosis, side effects of medication, medication compliance, functioning, and neurocognitive performance were assessed at four years.

Results: At four years, 65% of DD patients maintained the same diagnosis, while the rest shifted to SZ. Only those without a diagnostic shift were included in the analysis. Delusional disorder patients (n = 46) experienced greater general psychopathology and poorer insight, but better attitude towards medication than schizophrenia patients (n = 71). Social and occupational functioning, quality of life, and cognitive functioning, however, were similar in delusional disorder and schizophrenia patients.

Conclusions: Results indicate that delusional disorder is less diagnostically stable than schizophrenia. Their outcomes in a Chinese population were largely similar at four years after removing the confounding age factor, implying that delusional disorder and schizophrenia may not be as distinct as previously thought.

Keywords: Paranoid schizophrenia; Psychopathology; Psychosocial functioning; Psychotic disorders; Schizophrenia.

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Conflict of interest statement

EYHC reports having received speaker honoraria from Otsuka and DSK BioPharma; received research funding from Otsuka; participated in paid advisory boards for Jansen and DSK BioPharma; received funding to attend conferences from Otsuka and DSK BioPharma. All other authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Flow diagram of patients at each phase of the study
See this image and copyright information in PMC

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