2011 issue 4

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Volume 20, issue 4

Original article

Delusion or no delusion? Psychiatrists classifying verbal messages of patients with a prior history of psychotic disorder as delusional or non-delusional judgments

Sławomir Murawiec1
1. Centrum Zdrowia Psychicznego Instytut Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2011; 20(4): 277–282
Keywords: delusions, definition, pharmacotherapy

Abstract

Background. Whether patients' verbal messages are classified by psychiatrists as delusional or non-delusional judgments may depend, at least to some extent, on their definition of "delusion". The definition currently in force may be insufficiently precise. While enabling to accurately categorize delusions in the acute phase of psychosis, it does not allow to distinguish delusions from inadequate or bizarre cognitive judgments in the period following a successful antipsychotic treatment. The aim of the study was to assess whether current understanding of delusions by practicing psychiatrists ensures that they unambiguously classify their patients' verbal messages as delusional or non-delusional judgments.
Method. Participants in the study were 62 psychiatrists (58% with second degree specialty in psychiatry), who responded to a questionnaire presenting a hypothetical case. They were asked then to answer a series of questions: firstly, to classify the presented patient utterances as delusional or non-delusional, and secondly, to predict the patient's response to pharmacological treatment.
Results. All the interviewed psychiatrists classified the patient's verbal messages in the acute psychosis as delusional, while these from the post-treatment period were classified as delusions by 73% of the respondents and as non-delusional by the remaining 27%. In the latter group (classifying the post-treatment verbal output as delusional), a considerable percentage of respondents predicted a different response to pharmacotherapy on the grounds of the patient's utterances produced in the acute stage of psychosis and in the post-treatment period.
Conclusions. The definition of delusions currently in force is not precise and requires further clarification.

Address for correspondence:
Dr Sławomir Murawiec
Centrum Zdrowia Psychicznego Instytut Psychiatrii i Neurologii
ul. Sobieskiego 9, 02‒957 Warszawa
tel: 22 4582751
e-mail: murawiec@ipin.edu.pl