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Delusional disorder and schizophrenia: a comparison of the neurocognitive and clinical characteristics in first-episode patients

Published online by Cambridge University Press:  03 June 2015

C. L. M. Hui ,
E. H. M. Lee ,
W. C. Chang ,
S. K. W. Chan ,
J. Lin ,
J. Q. Xu  and
E. Y. H. Chen
C. L. M. Hui
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
E. H. M. Lee*
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
W. C. Chang
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
S. K. W. Chan
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
J. Lin
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
J. Q. Xu
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
E. Y. H. Chen
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, SAR, China
*
*Address for correspondence: Dr E. M. H. Lee, Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China. (Email: edwinlhm@hku.hk)
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Abstract

Background.

Delusional disorder (DD) is thought to be distinct from schizophrenia (SZ). However, few systematic investigations have been conducted on DD because of the difficulty in ascertaining a representative sample size. Existing knowledge has been mostly generated from inpatient cohorts, which may be biased towards a more severe sample.

Method.

We compared the demographic, clinical and cognitive differences between 71 patients with first-episode DD and 71 age-matched patients with first-episode SZ. Participants were consecutively recruited from a population-based territory-wide study of early psychosis in Hong Kong targeting first-episode psychosis. Basic demographic information, premorbid functioning, duration of untreated psychosis, pathways to care, symptomatology, social, occupational, and cognitive functioning were comprehensively assessed using standardized measurements.

Results.

Patients with DD had less premorbid schizoid and schizotypal traits compared to patients with SZ. More patients with DD were married compared to patients with SZ. However, at first episode, there were no significant differences between the two groups in regards to the duration of untreated psychosis, pathways to care, symptom severity, neurocognitive performance, treatment, and functioning.

Conclusions.

Our findings challenge previous thinking that patients with DD had better functioning than patients with SZ. This study not only provides an updated perspective into conceptualizing the clinical differences between DD and SZ, but also expands the descriptive account of the two disorders to include the neurocognitive dimension.

Keywords

Delusional disorderfirst episodeneurocognitionschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 14 , October 2015 , pp. 3085 - 3095
Copyright
Copyright © Cambridge University Press 2015 

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