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Delusion Themes Stay Consistent Across Psychosis Episodes, Study Finds
Delusion content was similar across episodes of psychosis in patients who relapsed over a 2-year naturalistic course of care, according to a study published in JAMA Psychiatry.
“In this longitudinal observational study, delusion content remained consistent across episodes of psychosis, which has relevance for recognition of early warning signs and relapse prevention,” wrote the research team from the psychiatry department at McGill University, Montréal, Quebec, Canada, “and results also suggested a need to maintain, rather than reduce, the intensity of interventions across the entire follow-up period in early intervention settings.”
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The longitudinal, observational study included 636 patients with affective or nonaffective first-episode psychosis enrolled in an early intervention service for people with psychosis in Montréal. Researchers analyzed patient data, including the thematic content of delusions and their severity, across the initial psychosis episode, remission, and relapse over 2 years of follow-up.
Among patients, 591 had baseline delusions, of whom 94.4% achieved remission. About a third of patients who achieved remission went on to experience a subsequent relapse to a second or later psychosis episode, according to the study.
A large proportion (63.2%) of patients who experienced relapse reported threshold-level delusions, the study found. Among them, 90.4% had thematic delusion content consistent with the first psychosis episode. Patients who relapsed with delusions reported fewer delusion themes compared with the first episode. Additionally, other psychotic and nonpsychotic symptoms occurred at lower levels.
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