VULNERABILITY TO DELUSIONS OVER TIME IN SCHIZOPHRENIA AND AFFECTIVE-DISORDERS

This research used a prospective longitudinal design to study differen ces in vulnerability to delusions over time in 234 subjects with schiz ophrenia, schizoaffective disorder, or bipolar or unipolar affective d isorder. Patients were assessed at three successive followups over a 7 - to 8-year period. Over 60 percent of the schizophrenia and schizoaff ective patients assessed experienced delusional activity at one of the three followups. Over 60 percent of the patients who initially had ps ychotic affective disorders also showed posthospital delusional activi ty. Significantly more schizophrenia patients than psychotic affective -disordered patients experienced consistent posthospital delusional ac tivity at three successive followups. Unlike the schizophrenia subject s, affective patients showed a significant reduction in delusions afte r the first followup. After the initial acute psychotic episode that l ed to hospitalization, psychotic bipolar and unipolar affective patien ts showed a traitlike vulnerability to episodic delusional activity ov er time, but schizophrenia patients were vulnerable to more severe del usional activity and to more frequently recurring or sustained delusio ns. The study results question the views of several major theorists on the importance, persistence, and prognostic significance of delusions in schizophrenia.