The purpose of the study was to examine first-admitted patients with delusional psychosis regarding social background, course and outcome. The study was handicapped by the lack of data of social variables as regards population in the catchment area, so comparisons were made with the population in the County and in the Nation. The index population comprised 88 patients. Social variables such as civil state and cohabitation are presented. At admission one-third had been employed continuously during the past year, while one-fourth had had no useful work at all. Significantly more patients were recruited from the lowest social group. Significantly more patients had inadequate social support, and two-thirds met friends less than once a week on an average. Only one-fourth of the patients seemed socially well adjusted and economically self-supporting. At follow-up 2 years later the distribution of the patients as regards useful work, social support, social contacts and social adjustment has significantly changed with more patients now with less useful work and social support, fewer social contacts and increased social maladjustment. The difficulty of interpretation of the findings is stressed but it is concluded that the present psychiatric treatment including social intervention is insufficient to prevent this social downlift mobility during a 2-year observation period as regards patients with delusional psychosis. Further study will search for social predictors of course and outcome.