A cross-sectional survey of the frequency and characteristics of delusions in acute psychiatric wards.
OBJECTIVE
The aim of this paper was to ascertain the frequency and characteristics of delusions across several acute psychiatric wards.


METHODS
A survey of the files of all 160 acute psychiatric inpatients aged 18-65 years within Western Sydney was conducted. Patients recorded as currently delusional were compared to non-delusional psychotic patients on demographic data, diagnoses, reason for admission, mode of admission, length of hospital stay, legal status, and treatments.


RESULTS
More than one-half of all patients in the acute psychiatric wards were recorded as being delusional. Persecutory delusions were found in 80% of delusional patients, and multiple delusions were common. Most delusions were steady in course, and 40% lasted longer than 6 months. Patients with delusions received a diagnosis of schizophrenia in 67% of the cases, while 72% of patients with schizophrenia were recorded as having delusions. Almost 90% of delusional patients were detained involuntarily. Antipsychotic medications were the mainstay of treatment for delusional patients, and 30% were treated with more than one antipsychotic. Non-pharmacological strategies for managing delusions were not used.


CONCLUSIONS
Delusions are commonly seen in acute psychiatric wards. There may be a relationship between the presence of delusions, severity of illness and treatment resistance. This highlights the need for a broad and more effective approach to management.
Brakoulias
Vlasios
V
University of Sydney, Sydney, NSW, Australia. vbrakoulias@bigpond.com
Starcevic
Vladan
V
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D003702:Delusions / Q000453:epidemiology* / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000453:epidemiology / Q000534:rehabilitation*