Clinico-Epidemiological Comparison of Delusion Prominent and Hallucination Prominent Clinical Subgroups of Paranoid Schizophrenia OutpatientsAuthor(s): Anatoly Kreinin*, Mariia Ivenski, Dmitry Ivenski and Michael Kirby
Objective: The primary goal of this replication study was to confirm previous findings which demonstrated that there are epidemiological and clinical differences between the hallucinatory and delusional subgroups of patients diagnosed with paranoid schizophrenia. In contrast, and as an extension to the previous study, which evaluated hostel patients, the in the current study we evaluated outpatients with paranoid schizophrenia. In addition, we sought to verify our assertion that within the spectrum of schizophrenia disorders, among patients with paranoid schizophrenia there are at least two sufficiently homogeneous subgroups with distinctive clinical and epidemiological characteristics.
Methods: Paranoid schizophrenia outpatients (n=100) meeting inclusion criteria and not violating exclusion criteria were randomly selected from a 2590 schizophrenia patient database. Patients were segregated into two groupings based on the Tirat Carmel criteria for Paranoid Schizophrenia (TCPS). Paranoid schizophrenia, hallucinatory subgroup (Subgroup H): Patients had a least one hallucinatory episode that lasted for more than a month within five years of illness onset. Paranoid schizophrenia, delusional subgroup (Subgroup D): Patients diagnosed with schizophrenia that did not fulfill criteria for the first group. Score results of Clinical Global Impression (CGI), Positive and Negative Syndrome Scale, (PANSS-8), Psychosocial Remission in Schizophrenia Scale (PSRS), and Quality of Life Enjoyment and Satisfaction Questionnaire 18 (QLES-Q-18) scales were compared between TCPS patient groups. Results: Subgroup H patients had significantly higher scores in positive and negative symptom categories of PANSS, as well as higher scores in all of the PSRS score categories, compared with Subgroup D patients. Over half of the QLES-Q-18 scores were significantly higher in Subgroup H patients compared with Subgroup D patients.
Conclusion: We found strong corroboratory evidence between TCPS groups and accepted psychiatric evaluation scales, suggesting the existence of paranoid schizophrenia subgroups.