DELUSIONS of SCHIZOPHRENIA
A CLINICAL STUDY ON A GROUP OF IRAQI PATIENTS IN DIWANIYA TEACHING HOSPITAL & AL-
RASHAD MENTAL HOSPITAL.
RESEARCH by
DR. KAREEM NASIR HUSAIN
M.B.CH.B, F.I.C.M.S,
__________________________________________
ABSTRACT
Back ground : deluesions may be difiened as false an shakeable beliefs of morbid orgins . their
chareteristics include :
1- non-acceptance by people of the same soical , religions, educational and back graunds .
2- The absolute conviction with which they are held and their incorrigibility by experiense or
argument .
3- their content are oflen , though not always absurd or impossible
Objectives : to Identify types and frequency of delusions in group of iraqi patients with
schizophreniform disorder and chronic schizophrenia.
Methods : this is cross sectional of study that enrolled 120 patient sixty schizophreniform patients
( acut schizophrenia) from Al- Diwaynia teaching hospital and sixty chronic schizophrenic patients
from AL-Rshad mental hospital
During period from 1 Jun 2008 to 1st Aug 2008 the patients was diagnosed as schizophreniform
psychosis or chronic schizophrenia by
Consultant psychiatrist and was confirmed by criteria of structural clinical interview for the
diagnostic and statisical manual of mental disorder text revision(DSM – I V – TR ) appendix -11-
they were selected consecutively by taking evry patient who fulfilled the diagnostic criteria
Result : this study revealed that the freguency of delusions among schizophreniform group of
patients were segnificantly highter then among the chronic schizophrenic ones . and highly
segnificant correlation between delusions and education level was found the higher the educational
level the more frequent were the delusions
There was no - signficont association between delusions and some other sociodemographic factors
Conclusions : this study proved that schizophrenform psychosis is presented with high rate of
delusions of all types and in particular persecutory delusions and delusions of reference and chronic
schizophrenic patients in frequenay had experiensed delusions when compeny . with
schizophrenform patients .
INTRODUCTION
DEFINITION OF DELUSIONS:
Delusions may be defined as false unshakeable beliefs of morbid origins. Their characteristics
include:
a) Non-acceptance by people of the same social, religious, educational and backgrounds.
b) The absolute conviction with which they are held and their incorrigibility by experience or
argument.
c) Their contents are often, though not always absurd or impossible.(3)
CLASSIFICATION of DELUSIONS:
Delusions can be classified as:
a) Primary delusions, also known as apophanous delusions, delusions proper or true delusions.
They are the result of a primary delusional experience which cannot be deduced from any
other morbid phenomenon. The essence of primary delusional experience is that a new
meaning arises in connection with some other psychological event.(1)
1
Fish (1967b) has linked them to the " brain wave " of normal individual where an
idea presents itself suddenly in consciously, but primary delusion has the
characteristics(1)
.
Schneider has suggested that experiences can be reduced to three; viz delusional
mood, delusional perception (apophanous) and sudden delusional ideas
(autochthonous delusion)(1)
.
b) Secondary delusions also known as delusion like ideas or delusional ideas.
They can be understood arising from other morbid experience, e.g.
schizophrenia may have delusions of persecution secondary to auditory
hallucination(3)
.
Secondary delusions include delusions of persecution, reference, nihilistic
delusion, delusion of guilt, religious delusion and delusion of control …………..
etc. delusions should be differentiated from over-valued ideas.
Over-valued ideas: thought which because of the associated feeling tone, takes the
precedence over all other thoughts, permanently for a long period of time(3)
.
MECHANISM of SOME DELUSIONS:
Delusion of persecution: They are usually secondary to other experiences
such as auditory hallucination, bodily hallucination or passivity experience(3)
.
TYPE OF DELUSION
DELUSION of INFLUENCE or CONTROL:
It may result from experiences of passivity which are attributed to hypnotism,
demoniacal possession, witchcraft, radio-waves, atomic rays and television(3)
.
DELUSIONS OF LOVE (EROTOMANIA, FANTASY LOVER):
They may result from hallucinatory voices, confabulation, fantastic
hallucination and elevated mood(1)
.
DELUSION of ILL-HEALTH (HYPOCHONDRIACAL DELUSIONS):
Schneider suggested that hypochondriacal delusions are the result of
uncovering of the patient's basic worries about health(3)
.
NIHILISTIC DELUSIONS (DELUSION of NEGATION):
The patient denies the existence of his body, his mind, his loved ones and the
world around so the denial is the underlying mechanic(3)
.
PATIENT'S ATTITUDE TO DELUSIONS:
Patients with delusions do not necessarily act on them despite they are
convinced that their delusions are true. In chronic schizophrenia, there is
discrepancy between the delusions and the patient's behaviour(3)
.
Hypochondriacal delusions may lead to suicide or homicide. In case of
delusions of jealousy it would seem that the action is more likely to be taken on the
basis of true delusions because true delusions are the result of dis-integration of the
personality while over-valued ideas occur in an intact personality(3)
.
2
DELUSIONS of CULTURE:
In 1904, Kraepelin concluded that Javanese natives showed few paranoid
symptoms and he attributed that attributed that to the fact that at that time the
abstract thinking of most natives in Java was still relatively undeveloped(10)
.
In Egypt, Okasha found that the persecutory delusions with ideas of reference
were the rule, delusions of grandeur were not common. Systematized delusions
were not common except in the educated group(10)
.
Zarrouk(15)
who studied Arab schizophrenia in Saudi Arabia had pointed out that
care has to be taken in eliciting symptoms in Saudi Arabia society where belief in
possible adverse influence of the Devil (Shaitan) on man is entertained by normal
people. He added that only the psychiatrist who is experienced in the Arabian
culture will be able to differentiate delusory cultural beliefs that receive general
acceptance from delusion that indicate pathological deviance beyond what is
culturally shared. He also compared Saudian Arabic schizophrenic patients with
the English patients of Mellor (1970)(9)
. He found that somatic passivity, made
impulsive, made volition and made affect were the most frequent symptoms that
were higher than in English patients(1)
.
Stainbrook has noted that the delusions of middle class Brazilian are
expressed in the terms of economic and class conceptions of power, along with
such impersonal influences as that of electricity and physical waves(10)
.
Amara noted that primary delusions are at best difficult to elicit in African
patients. Secondary delusions of grandeur, religion, nihilism, passivity and
persecution are the most common(11)
.
Sherman studied mixed American population and Lucas studied mixed
English subjects. They noted that delusions pattern and formations were affected
by cultural back background(10)
.
Tateyama – M, Asai-M, Kamisada – M, Hashimoto- M, Bartels-M,
Heimann-H studied the content of schizophrenic delusions of German patients and
those Japanese patients. They found that significantly higher frequencies of
delusions of poisoning in the cases.
Among the persecution/injury delusions, themes of direct persecution from others
were conspicuous in the German group, whereas delusions of reference related to
harassment, such as 'being slandered by others' or 'being known', were common in
the Japanese group(5)
.
Kim-KI, Li-D, Jiang-Z, Cui-X, Lin-L found that many delusions were
shown to be different among Koreans, Koreans-China and Chinese groups. They
were different among Korean-Chinese. They were different in their frequency and
the content and the differences could be explained by sociocultural or political
factors(11)
.
3
AI-Issa suggested that paranoid delusions in an illiterate culture may tend to appear
in action (assaulting or killing somebody) rather than thought. He also suggested
that contrary to the prediction from cross – cultural studies, paranoid delusions
were not significantly related to literacy(4)
.
SCHIZOPHRENIFORM PSYCHOSIS
It is superficially a psychosis similar to schizophrenia, Langfeldt sought to
distinguish between schizophrenia and schizophreniform psychosis on the
following:
Symptomatology, outcome, response to Electroconvulsive Therapy and insulin
coma therapy(4)
.
In U.S.A, Elgin, Philps and Kantor tried to discriminate between schizophrenia
and schizophreniform psychosis mainly on the basis of the premorbid personality
and psychosexual adjustments. Both Langfeldt and American workers assumed
that schizophrenia was endogenous and hereditary and that schizophreniform
psychosis was psychogenic but neither succeeded to put a clear demarcation
between the two. Langfeldt proposed that schizopgreniform had a good prognosis
and schizophrenia had a poor prognosis.(4)
OPERATIONAL DEFINITION OF SCHIZOPHRENIA:
1- Diagnostic and statistical Manual of Mental Disorders, fourth edition,
revised (DSM-IV)(1994)(12)
.
This criterion gives narrow definitions of schizophrenia and relies mostly on
describable signs and symptoms. It needs at least six months duration of
continuous signs of disturbance to diagnose schizophrenia.
Schizophreniform disorder meets the DSMIV-cross-sectional criteria for
schizophrenia except that it lasts less than months and more than month. Emotional
turmoil and confusion are more likely occur in schizophreniform disorder than
schizophrenia.
2- International Classification of Diseases (I.C.D. 10)(WHO, 1989)(14)
.
According to this system, diagnosis of acute schizophrenia (equal to
schizophreniform disorders in DSMIV-R) needs a duration of disturbance not less
than one month during which characteristic symptoms mostly first rank symptoms
must be present.
Significance of Delusions for Diagnosis of Schizophrenia:
Delusions rank the second in USA, eighth in Great Britain and tenth in
Egypt. Paranoid delusions rank second in USA sixth Great Britain and download
Egypt(2)
.
In Egypt hierarchy, thought withdrawal was fourth rank, passivity feeling was sixth
rank, near that in Great Britain but widely apart in USA(9)
.
4
Thought-withdrawal ranked fourteenth, and passivity feelings ranked twenty-
ninth in USA(13)
.
Delusions in USA were highly significant for diagnosis of schizophrenia where
they ranked second(13)
.
In Egypt, Egyptian Manual stated that delusions are not necessarily present in
schizophrenia and also stated that delusions and hallucinations alone are not
sufficient to diagnose paranoid schizophrenia(1)
.
AIM OF THE STUDY
- To identify types and frequency of delusions in a group of Iraqi patients with
schizophreniform disorder and chronic schizophrenia.
- To study the relationship between delusions and some sociodemographic factors
such as: age, sex, marital state and educational level in both schizophreniform and
chronic schizophrenia patients.
PATIENTS AND METHODS
Sixty patients (30 male, 30 females) with schizophreniform disorders (acute
sschizophrenia) and sixty patients (30 males and 30 females) with chronic
schizophrenia were crossed –sectionally studied. They were selected consecutively
by taking every patient who fulfilled the following diagnostic criteria:
1- The patients was diagnosed as schizophreniform psychosis (acute
schizophrenia) or chronic schizophrenia by a consultant psychiatrist in
charge.
2- The diagnosis was confirmed by DMSIVR based semistructured interview
schedule (Appendix I).
3- Patients in both groups fulfilled the DSMIVR criteria for schizophreniform
disorder and chronic schizophrenia (Appendix I).
The schizophreniform group consists of sixty patients (30 males and 30
females) with a mean = 33.8, age, rang of 20 – 45 years (33.8 6.3).the patients
were examined within a maximum of two days from admission in the hospital to
allow accurate assessment of symptoms before they had been substantially
modified by the treatment. The patients this group had acute illness for the first
time.
These patients had informants with them who could detail description of the
behaiour during the current illness.
The chronic schizophrenic group consists of sixty patients (30 and 30
females) with a mean age = 45.3, an age range of 22-74 (54.3 11.5)
4-The data were collected and analysed by chi-squared test to find out any
significant correlation between delusions and some sociodemographic variables
such as age, sex, marital status and educational level in both groups of patients.
RESULTS:Table (1) demonstrates the marital status of the schizophreniform
group of patients. It reveals that more than half of the patients, both males (6%)
and females
5
(56.7%), were single and that there were only three patients (10%)
who were widowed; all of them were females.
The marital status of chronic schizophrenic is presented in table (2). Again
the majority of this group of patients were single (66.67% males and 30%
females), and three is only two patients (3.3%) were widowed (1 male and 1
female).
The types and frequencies of delusions among schizophreniform group
demonstrated in table (3), which showed that 86.6% of patients had persecutory
delusions and 70% of them had delusions of reference. The lowest frequency was
the nihilistic delusion 6.6% .
Table (4) presents types and frequencies of delusions among the group with
chronic schizophrenia which shows that the frequency of delusions was much less
than schizophreniform group and again persecutory delusions delusions come on
the top of the list (20%).
The frequency of delusions was studied in relationship to several
sociodemographic variables in both groups as shown in table (5).
No significant relationship had been found with age, sex, and marital status.
A high significant relationship had been found with the educational level viz; those
with high education had higher rate of delusions than those with low educational
level. Paranoid delusions were found more commonly in the less educated groups.
Table (1): Marital status among the patients with schizophrenia psychosis:
MALE FEMALE TOTAL
marital status No. % No. % No. %
Single 18 60 17 56.7 35 58.35
Married 7 23.4 8 26.7 15 25.05
Divorced 5 16.6 2 6.6 7 11.6
Widowed 0 0 3 10 3 5
Total 30 100% 30 100% 60 100%
Table(2):Marital status among the patients with chronic schizophrenia.
Male Female Total
Marital status No. % No. % No. %
Single 20 66.67 9 30 29 48.34
Married 7 23.33 11 36.67 18 30
Divorced 2 6.67 9 30 11 18.34
Widowed 1 3.33 1 3.33 2 3.33
Total 30 100% 30 100% 60 100%
6
Table (3) : Types and frequencies of delusions among the with schizophreniform
psychosis.
Typesof delusions
Male =30 Female=30 Total=60
No % No % No %
Persecutory 25 83.3 27 90 52 86.6
Delusion 22 73.34 20 66.66 42 70
Thought
alienation
17 56.6 15 50 32 53.3
Thought
broadcasting
15 50 12 40 27 45
Thought
withdrawal
5 16.6 6 20 11 18.3
Thought insertion 6 20 4 13.3 32 16.65
Passivity
experiences
16 53.3 16 53.3 32 53.3
Somatic passivity 7 23.3 6 20 13 21.65
Made act 4 13.3 5 16.6 9 14.95
Made impulse 3 10 2 6.6 5 8.3
Made affect 2 6.6 3 10 5 8.3
Grandiose
delusion
15 50 14 46.6 29 48.3
Religious
delusion
8 26.6 10 33.3 18 29.95
Somatic delusion 7 23.3 5 16.6 12 19.95
Delusion
perception
2 6.6 3 10 5 8.3
Nihilistic delusion 3 10 1 3.3 4 6.65
7
Table (4): Types and frequencies of delusions among chronic schizophrenic patients.
Types of delusions Male = 30 Female = 30 Totale = 60
No. % No. % No. %
Persecutory
delusion
8 26.66 4 13.33 12 20
Grandiose delusion 1 3.33 3 10 4 6.66
Delusion of
reference
1 3.33 2 6.66 3 5
passivity
experience
1 3.33 1 3.33 2 3.33
Somatic passivity 1 3.33 1 3.33 2 3.33
Made affect 1 3.33 1 3.33 2 3.33
Made act 0 0 1 3.33 1 1.66
Made impulse 0 0 1 3.33 1 1.66
Thought alienation 2 6.66 1 3.33 3 5
Thought
broadcasting
1 3.33 1 3.33 2 3.33
Thought insertion 1 3.33 1 3.33 2 3.33
Thought
withdrawal
1 3.33 1 3.33 2 3.33
Religious 0 0 1 3.33 1 1.66
Nihilistic delusion 1 3.33 0 0 1 1.66
Table (5): Frequency of delusions according to demographic variables (age, sex, marital
status and educational level) among schizophreniform patients.
Demographic variables Delusions
sex:
Male
female
Present Absent Total
X2=0.56,
df=1,
p>0.05
No. % No. % No
.
%
25 41.66 5 8.34 30 50
27 45 3 5 30 50
Total 52 86.66 8 13.34 60 100
Age: 16-35 year
36-45 year
36 60 5 8.34 41 68.34
X2=0.04,
df=1,
p>0.05
16 26.66 3 5 19 31.66
Total 52 86.66 8 13.34 60 100
Marital Status:
Single
Married
Divorced
Widowed
X2=4.04,
df=3,
p>0.05
32 53. 34 3 5 35 58.34
13 21. 66 2 3.34 15 25
6 10 1 1.66 7 11.6
1 1.66 2 3.34 3 5
Total 52 86.66 8 13.34 60 100
Educational Level
Primary level or lower
Secondary education or higher
X2=8.08,
df=2,
p<0.01
12 20 6 10 18 30
40 66.66 2 3.34 42 70
Total 52 86.66 8 13.34 60 100
8
DISCUSSION
The present study has showed that the schizophreniform group had high
frequency of persecutory delusions (86.6%). This is somehow identical or close to
the frequencies reported by other authors
However the frequency of persecutory delusions in this study was higher
than in Jamaican and Middle eastern schizophrenic patients studied by Ndetei and
Vadher (1984)(3)
, who found the frequency to be of 27% for both groups. Also it is
higher than in Kinyan groups reported by Ndetei and Singh (1982) 47%(11)
.
This high frequency of persecutory delusions in this study could be due to
cultural factors such as the wide spread belief in witchcraft and tendency to explain
events in term of external causation(6)
.
Delusion of reference was elicited in 70% of the cases which is rather
higher than other studies such as Ndetei – Singh's (1982) study on Kenyan
patients(7)
, but identical to those reported by Abid (1987)(11)
78% on Iraqi
schizophrenic patients(21)
. The frequency of grandiose delusions (48%) was rather
identical to other studies such as Ndetei-Singh (1982) on Kenyan patients(11)
and
Lucas (1962) on English patients(6)
.
PASSIVITY EXPERIENCE:
In this study, it was found nearly equal to the study of Landmark et al
(1987)(7)
, but less than Saudi Arabian group who has been studied by Zarrouk
(1978)(15)
.
THOUGHT BROADCASTING:
However Zarrouk (1978)(15)
reported lower frequency in the Saudi Arabian
schizophrenic(4)
. Also lower frequencies were reported by Mellor (1970)(8)
in
English patients.
THOUGHT WITHDRAWAL:
It was found to be close to the study by Zarrouk (1978)(15)
on Saudi Arab
patients. The frequency of thought withdrawal was found to be higher than the
study by Ahmed (1987) on Labour group(7)
.
THOUGHT INSERTION:
It was found to be similar to one published study in developing countries
which was Zarrouk's (1978) study on Saudi Arab group(2)
. It was less frequent than
Mellor's (1970) study on English group(8)
.
Delusions in the chronic schizophrenic group in general were much lower in
frequency than in the schizophreniform group; Table (3) and Table (4).
It was again revealed a significant relationship between delusions and
educational level, where those with high education had higher rate of delusions,
than those with low educational level. Paranoid delusions only were found more
commonly in the less educated group which can be explained on the basis than in a
culture with a wide spread belief in witchcraft, believed to be a tool of harm, it is
not a surprising that the less educated have more paranoid delusions than
9
the more educated with their wider and more scientific view of the world. Further
it is possible that the more educated have over all more delusions simply because
the less educated are culturally more predisposed to the development of paranoid
delusions.
CONCLUSION
This study shows the following:
1. Schizophreniform psychosis is presented with a high rate of
delusions of all types and in particular persecutory
delusions and delusions of reference.
2. Chronic schizophrenic patients infrequently had
experienced delusion when compared with the
schizophreniform patients.
3. The frequency of delusions was not influenced by age, sex,
or marital status.
4. Delusions were more frequent amongst the highly educated
class of patients.
10
REFERENCES
1- Al-Issa (1970), culture and symptoms, In: Costello C. G(ed), symptoms of
psychopathy, a hand-book, Chapter 2, pp 27-29, John Willy and sons,
London.
2- Comprehensive Text-book of Psychiatry, Sadock Kraplen, 2004.
3- Hamilton M. (2007) ed, Fish's clinical psychopathy: Signs and symptoms in
psychiatry, chapter 4, pp 43-53, second edition, Wright Bristol.
4- Langfelt G, (1990), Diagnosis and prognosis to schizophrenia, Proceedings
of the Royal Society of Medicine 53: 1047, In: R.E. Kendell (1988) ed,
Schizophrenia , In: Compania to psychiatric studies (edited by R.E Kendell
A.K Zeally) Chadter 16, P311 , 4th edition ,Churchill Livingstone Edindurgh.
5- Louis appleby . Delusional disorder , postgraduat , second edition 2001
page 350
6- Lucas C.J, Sainbury P , Collins J.G(1962) , The social and clinical study of
delusions in schizophrenia , British Journal of Psychiatry 108:747-758, In:
K.G Grossman (1971) ed, Recent advances in clinical psychiatry, chap2, pp
54-57, J and A Churchill, London.
7- Malik S.B, Ahmed M., Bashir A. and Chauddry T. M., 1990, Shneider's
First Rank, Symptoms of Schizophrenia , Prevalence and Diagnostic Use,
Brith Journal of Psychiatry, 156: 109-111.
8- Mellor C.s (1970), First rank Symptoms of Schizophrenia, British Journal of
Psychiatry, 117, 15-53.
9- Michael gelder, phelip cowen, delusional disorder , shorter
oxford textbok , fourth edition 2004 , page 708
10- Ndetei D.M and Vadher A. (1984), Frequency and clinical
significance of delusions across culture, Acta Psychiatrica Scandinavica, 70:
73-76.
11- Ndetie D.M, Singh A. (1982), Study of delusions in Kenyan
schizophrenic patients diagnosed using a set of research diagnostic criteria,
Acta Psychiatrica Scandinavica, 66: 208- 215.
12- S.M. Lawrie: Companion to psychiatric study, seventh edition (2004),
page 369-399.
13- Thedor E.A stern, psychopathy, psychiatry update and board
preparation, 2002.
14- W.H.O (1989) , Tenth Revision of the Internatioal Classification of
Disease (I.C.D 10), cheap V, copy right© . F20, p64.
15- Zarrouk E.A-(1978), The usefulness of first rank symptoms in the
diagnosis of schizophrenia in a Saudi Arabian Population, British Journal of
psychiatry, 132, 571-573.
11
APPENDIX 1
إصتبيا يرضي فصاو انعقم انضتنذ
انعذل نرابععهي انكراس الاحصائي انتشخيصي ا
SEMISTRUCTURED INTERVIEW
DERIVED FROM DSMIVR
الاصى -1
انعر )تأريخ انولادة( -2
أنثي انجنش ركر -3
أعزب يتزوج يطهق أريم انحانت انزوجيت -4
انضتوى انثقافي: انذراصت الابتذائيت فا دو انذراصت انثانويت فا فوق -5
12
APPENDIX II
Diagnostic Criteria for Schizophrenia (DSMIV-R)
A- presence of characteristic psychotic symptoms in the active phase: either (1)
, (2), or (3) for at least one month ( unless the symptoms are successfully
treated):
1- Two of the following
a) Delusions.
b) prominent hallucinations (throughout the day for several days or several
times a week for several weeks , each hallucinatory experience not being
limited to a few brief moments).
c) In coherence or marked loosening of associations.
d) ca ???? tatonic behaviour.
e) flat or grossly inappropriate affect.
2- Bizarre delusions (i.e., involving a phenomenon that the person's culture
would regarded as totally implausible, i.e., thought broadcasting, being
controlled by a dead person).
3- Prominent hallucinations [as defined in (1) (b) above] of a voice with
content having no apparent relation to depression or elation, or a voice
keeping up running commentary on the person's behaviour or thoughts, or
two or more voices conversing with each other.
B- During the course of disturbance, functioning in such areas as work, social
relations, and self-care is markedly below the highest level achieved before
onset of the disturbance (or, when the onset is in childhood or adolescence,
failure to achieve expected level of social development).
4- Subchronic with acute exacerbation. Re-emergence of prominent psychotic
symptoms in a person with a chronic course who has been in the residual
phase of the disturbance.
5- In Remission. When a person with a history of schizophrenia is free of all
signs of disturbance (whether or not on medication), "In Remission" should
be coded. Differentiating schizophrenia in Remission from No Mental
Disorder requires consideration of over all level of functioning, length of
time since the last episode of disturbance, total duration of disturbance, and
whether prophylactic treatment is being given.
6- Unspecified.
الخلاصة
عرف الوهم اعتقاد خاطئ إمن به صاحبه دون إن قتــــــنع بؤي دلل أو / الموضوع خلفية
نقاش أو منطق دحضه . وقد عرف آخرون الوهم على الشكل التال ) هو امان بحققة لا
تقبلها اناس من نفس طبقة وثقافة وجنس وزمان ذلك الشخص الذي إمن بها وبدون إن تغر
عول البراهن والجدل الذي دحضها ( مع ذلك فؤن تحدد الوهم شء صعب وخطر لان بمف
معظم الناس والاطبــــاء والمحامن مثلا عتبرون الأوهام من ابرز وأوضح الدلائل على
المرض العقل .
المصابن بالذهان العراقن لدى المرضى لحساب نسبة انتشار وانواع الأوهام/ الاهداف
ه الفصام ) الفصام الحاد( والفصام المزمن ومقارنتها مع بقة الدراسات ف العالم ولتقم شب
مختلف العــــــــــــوامل الدموغرافة على نسبة الحدوث
مرض 01مرض مصاب باضطراب الفصام 021هذه دراسة مقطعة شملت الطرق /
أناثا ف 01ذكورا و 01اد ( وكان المرضى مصــــــــاب بالذهان شبه الفصام ) الفصام الح
مستشفى الدوانـــــــة التعلم / شعبة الامراض النفسة .
مرضا مصابا بالفصام المزمن ف مستشفى الرشاد للامراض 01تناولت الدراسة اضا
لاول من آب أناثا ( تمت الدراسة من الاول من كانون الثان لغاة ا 01ذكورا و 01العقلة )
م وتم تشخص الاضطرابات طبقا لخصائص ومعار المقابلة السررة الهكلة 2112عام
المنقحة - 4 -للتشخص والدلـــــــــل الاحصائ من الاضطراب العقل
الاضطهادة الت عتقد ف الأوهام % من 20.0راسة بان نسبةالدهذه اثبتت النتائج /
ص اومجموعة من الناس او قوة خارجة كرهونه او ردون اذائه المرض بــان شخ
مصابن بالذهان شبه الفصام ) الفصام لدى المرضى الوخططون لذلك بصــــــــورة متعمدة .
% من اوهام الاشارة ) الذي عتقد فها المرض الاخرن تكلمون او 01الحاد ( وكذلك نسبة
% من اوهام العدمة ) عتقد فها المرض بانه غر موجود 0.0سخرون منه ( وكذلك نسبة
او على وشك موت او شئ مفجع قد وقع او على وشك حدوث او إن الكون على وشك نهاة
% اوهام اضطهادة عند المرضى المصابـــــن بالفصام المزمن 21( وكذلك نسبة
الاستنتاجات /
وهام بن المرضى المصابن بالذهان شبة ألنفصام اثبتت هذه الدراسة بان نسبة تكرار الأ
)ألفصــــــام الحاد ( ه أعلى من وجد بن أولئك المصابن بالفصام المزمن وبدرجة أحصائة
ممزة وكذلك هنـاك علاقة ممزة أحصائا بن نسبة الأوهام والمستوى الثقاف للمرض فؤن
د الناس ذات المستوى الثقاف الأقل تعلمآ . أظهرت الأوهام الاضطهادة أكثــــــــر شوعآ عن
هذه الدراسة أضا عدم وجود علاقة ذات أهمة أحصائة بن نسبة الأوهام والعوامل
الأجتماعة الدموغرافة )السكانة(الأخرى كالعمر. الجنس والحالة الزوجة