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. METHOD: 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.