妄想性障害の臨床的特徴と抗精神病薬への薬効性の前方視的研究

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A recent literature search revealed virtually no prospective studies regarding delusional disorder, including that in response to therapy so far. To delineate the clinical characteristics of delusional disorder, we prospectively compared patients with delusional disorder and those with schizophrenia diagnosed according to The Diagnostic and Statistical Manual of Mental Disorder, Fourth edition (DSM IV) criteria. All patients who visited the last author between January 2002 and December 2004 without a history of preceding medical treatment were included in the study. Those with other diseases potentially leading to secondary psychotic symptoms, such as dementia, meningo-encephalitis, brain tumors, and endocrinopathy, were excluded. Thus, 29 patients with delusional disorder (D group) and 43 with schizophrenia (S group) were selected as subjects. In addition to basic clinical data such as sex, age at onset, and duration of illness, Positive And Negative Syndrome Scale (PANSS) scores obtained at the initial examination and each month after the beginning of the study were assessed. Further, the maximum dosage of antipsychotic drugs administered during the follow-up period was calculated by converting that for all the antipsychotic drugs received into the corresponding value for risperidone. The results showed that age at onset was significantly higher in the D group than in the S group (t=8.244, p<0.001), and female/male ratio also tended to be higher in the D group (Pearson's chi square=2.862, p=0.091). In addition, the maximum dosage of antipsychotic drugs received was significantly lower in the D group than in the S group (t=3.941, p<0.001), while the reduction rate in total score of PANSS positive scale scores was significantly larger in the D group than in the S group (t=2.016, p=0.049). In conclusion, delusional disorder is shown to be an independent and treatable clinical entity.
2006-03-15

妄想性障害の臨床的特徴と抗精神病薬への薬効性の前方視的研究

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