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