Authors (including presenting author) :
Ting KT(1), Wong AWS(1)*
Affiliation :
(1) Clinical Psychology Department, Kowloon Hospital * Presenting author
Introduction :
As a key clinical symptom in schizophrenia, persecutory delusion is associated with increased suicidal risk and hospitalization. Although pharmacological intervention is considered the first-line treatment, patients’ poor adherence rate and the small to moderate treatment effects arouse attention to the needs of providing psychological intervention to maximize treatment gain among patients suffering from the distress of persecutory delusion. Past studies identified that worry and the associated processes contributed to the development and maintenance of persecutory delusion. A large-scale randomized controlled trial found a significant reduction in long-standing delusion after a brief intervention targeted at worry. Hence, considering the tight mental health service and patients’ access to psychotherapy, it is important and relevant to evaluate the applicability and effectiveness of this brief and time-limited worry intervention on improving persecutory delusion.
Objectives :
The objectives of the present study are to translate and localize the treatment protocol, to evaluate treatment effectiveness and patients' subjective experiences on the localized worry intervention.
Methodology :
This worry intervention consisted of 6 modules to be completed over 8 weeks. The treatment protocol was translated into Chinese with the permission of the original author. Cultural adaptation was made by using local examples. The target participants were individuals with persecutory delusion and significant worry as defined by The Psychotic Symptoms Rating Scale (PSYRATS) and Penn State Worry Questionnaire (PSWQ) respectively. Their levels of anxiety, perseverative thinking and well-being were also measured. All participants received psychiatric care at Kowloon Hospital.
Result & Outcome :
Fifteen participants received the worry intervention. Significant improvement was found in the persecutory delusion (t(14)=4.22, p=.001) and worry (t(14)=3.31, p=.005); perseverative thinking (t(14)=2.17, p=.048), and well-being (t(14)=-2.17, p=.048). Improving trend was observed in their anxiety level (t(14)=2.06, p=.058). The localized worry invention appeared to be equally effective in the Chinese population on their delusion and worry. Apart from Cognitive Behavioral Therapy for psychosis, people with persecutory delusion may benefit from brief intervention targeting at worry, especially for those who are not ready for verbal challenge on their delusion. The limitation of this study includes small sample size and the absence of controlled condition.
