![]() Certain features such as mild level of symptoms, atypical symptoms, short duration, and good premorbid personality indicate a favorable prognosis ( Kolada et al., 1994). It has been observed that OCD symptoms can switch (for example, from cleaning to checking or vice versa), but no systematic research has examined this phenomenon ( Rasmussen & Eisen, 1992a Tallis, 1995). Still, as in retrospective studies, more than three-quarters remained symptomatic and at least partially impaired by their symptoms.Ī number of unsystematic observations about the clinical course are worthy of note and further study. These patients showed a 22% probability of full remission and 53% for partial remission. A second study of 107 clinic patients followed up to five years after intake showed a slightly better outlook, probably because of a longer treatment follow-up ( Steketee, Eisen, Dyck, Warshaw, & Rasmussen, 1996). Of the remainder, 12% had minimal or no symptoms and 31% were partially improved and did not meet diagnostic criteria. (1995) observed that 57% of 51 subjects stillmet full criteria after two years, although some of these had improved substantially. Two recent prospective studies of clinical course assessed OCD symptoms using a Psychiatric Rating Scale that allowed determination of whether subjects met diagnostic criteria for OCD, had subclinical symptoms, or remitted entirely. Eisen and Steketee's (1997) recent review confirmed some of their conclusions: episodic OCD with full remissions occurs rarely (10–15%), although this percentage increased with longer follow-up periods. In a review of early follow-up studies, Goodwin, Guze, and Robins (1969) concluded that there were three types of clinical course in OCD: a chronic, unremitting course in which 10-15% of patients show deterioration, an episodic course with periods of complete remission, and an episodic course with periods of incomplete remission. ![]() Frost, in Comprehensive Clinical Psychology, 1998 6.17.3.2 Clinical Course It may be the case that measures applicable for normal and clinical populations are different. More specific rating scales and assessment devices have been developed for the assessment of delusions alone.ĭespite doubts about the validity and reliability of scales for the assessment of paranoia, the fact that they seem incestuous in their development, and their reliance on doubtful theories of personality structure, diagnosed patients with delusions of persecution score high on these measures, whereas nonpatient samples show predictable associations with other measures of cognitive functioning. Within such scales, however, delusional ideation is viewed as a part of a whole syndrome rather than as a phenomenon worth examining alone. A more precise assessment can be obtained using specific research devices. ![]() General psychiatric rating scales include brief assessments of the presence or absence of the symptoms of schizophrenia, including delusional beliefs. Delusions are also usually assessed on a variety of parameters: conviction, cultural or stimulus determinants, preoccupation, implausibility, extension (the degree to which the delusional belief involves various areas of the patient's life), bizarreness, disorganization, and emotional commitment. Thus, continua rather than dichotomous classifications may be appropriate. ![]() Paranoid ideation can be assessed in its own right as delusional beliefs or as a symptom of schizophrenia.ĭelusional classification is complex, and it is often difficult to determine the difference between unusual beliefs and full delusions, between brief episodes and persistent delusions, or between bizarre versus nonbizarre delusions. Kinderman, in Encyclopedia of Stress (Second Edition), 2007 Assessment In this chapter, we briefly review the development and psychometric characteristics of some of the most widely used psychiatric rating scales for depression, mania, generalized anxiety disorder, obsessive-compulsive disorder, schizophrenia, and dementia, as well as several of the common conditions in children and adolescents. Although primarily used to assess changes in illness severity during treatment trials (i.e., as dependent measures in randomized controlled trials), psychiatric rating scales also may be used as relatively brief screening tools for diagnosis and as useful tools in nonresearch settings to monitor illness activity and response to treatment within disease management or measurement-based care paradigms. Thase, in Handbook of Clinical Neurology, 2012 AbstractĪ wide array of psychiatric rating scales have been developed and refined over the past 50 years to provide reliable and objective assessments of the symptom severity of a large number of psychiatric disorders. ![]()
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