A descriptive case-register study of delusional disorder (original) (raw)
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Empirical redefinition of delusional disorder and its phenomenology: the DELIREMP study
Comprehensive Psychiatry, 2013
Aims: Since Kraepelin, the controversy has persisted surrounding the nature of delusional disorder (DD) as a separate nosological entity or its clinical subtypes. Nevertheless, there has been no systematic study of its psychopathological structure based on patient interviews. Our goal was to empirically explore syndromic subentities in DD. Methods: A cross-sectional study was conducted in 86 outpatients with DSM-IV-confirmed DD using SCID-I. Psychopathological factors were identified by factor analysis of PANSS scores. The association between these factors and clinical variables (as per standardized instruments) was analyzed using uni-and multivariate techniques. Results: PANSS symptoms were consistent with four factors (Paranoid, Cognitive, Schizoid, and Affective dimensions), accounting for 59.4% of the total variance. The Paranoid Dimension was associated with premorbid paranoid personality disorder, more adverse childhood experiences, chronic course, legal problems, worse global functioning, and poorer treatment adherence and response. The Cognitive Dimension was associated with poorer cognitive functioning, premorbid substance abuse, comorbid somatic diseases, mainly non-prominent visual hallucinations, fewer comorbid depressive disorders, and poorer global functioning. The Schizoid Dimension was associated with being single, a family history of schizophrenia, premorbid personality disorders (largely schizoid and schizotypal), non-prominent auditory hallucinations, and dysthymia. Finally, the Affective Dimension was associated with a family history of depression, premorbid obsessive personality, somatic delusions, absence of reference delusions, tactile and olfactory hallucinations, depressive and anxiety disorders, risk of suicide, and higher perceived stress. Conclusion: The identification and clinical validation of four separate psychopathological dimensions in DD provide evidence toward a more accurate conceptualization of DD and its types.
Revista de Psiquiatría y Salud Mental, 2009
We aim to describe psychosocial and clinical correlates of delusional disorder (DD) and its types. This approach is important because most knowledge on DD does not come from empirical data collected using a validated systematic research method. A cross-sectional study was conducted in a sample of 86 patients fulfilling DSM-IV criteria for DD as established using the SCID-I. Variables were evaluated using a systematic methodology and standardized instruments, and included possible psychosocial risk factors (low socioeconomic status or social isolation, immigration, sensory deficits, older age at onset), family history of psychiatric disorders and premorbid personality (SAP), psychotic psychopathology (PANSS), depressive syndrome (MADRS), global cognitive functioning (MMSE), axis I comorbidity (MINI) and other clinical aspects such as global functionality (GAF), and disability (SDI). A sociodemographic and clinical questionnaire was also completed. The mean age at onset was 39.6 years and 61.6% of the cases were female. The most frequent DD types were persecutory (59.3%) and jealous (22.1%). Nearly 21% had a family history of schizophrenia and 17.4% had DD (significantly higher among those with the jealous subtype). Sixty-four percent had a premorbid personality disorder (38.4% paranoid, 12.8% schizoid). The grandiose type was significantly associated with higher scores on the PANSS positive subscale and the mixed type with lower scores on the PANSS negative subscale. Depression affected 45.3% of subjects (mainly mild depression) and 45.3% had hallucinations (20.9% tactile, 16.3% olfactory), which were more common among somatic cases. The mean MMSE was 27.6±2.5 suggesting a preserved cognitive function. Mean GAF was 63.9±11.3 indicating a moderate degree of disability, which was significantly worse amongst grandiose cases. This study provides unique empirical and reliable evidence on the real psychosocial, clinical, and psychopathological correlates of DD and its types.
A Psychopathological Comparison between Delusional Disorder and Schizophrenia
The Canadian Journal of Psychiatry
Objective: To contribute to a better differential clinical categorisation of delusional disorder (DD) versus schizophrenia (SZ) and to add and complete evidence from previous clinical studies of DD compared to schizophrenia. Methods: A cross-sectional study using a clinical sample of 275 patients (132 patients with DD) was studied. Patients were consecutively attending public clinics located in urban and rural areas in both Andalusia and Catalonia (Spain). All participants met DSM-IV diagnostic criteria for either DD or SZ. Data were gathered on sociodemographics, illness duration, Barona-Index estimation of intelligence quotient (IQ), and global functioning, along with a thorough psychopathological assessment using the Positive and Negative Syndrome Scale (PANSS). Comparisons between both groups were calculated using χ2, Student t, and multivariate analysis of covariance tests. Results: Patients with DD were older (mean [SD], 50.3 [14.6] years vs. 36.6 [11.1] years; t = 8.597; P ≤ ...
Delusional Disorder - A Study from a General Hospital
Indian Journal of Psychological Medicine, 1991
Patients 111eeli1lg DSM 111-R criteria for Delusional Disorder (DD) were studicd by the analysis ofcase records. Frequency of DDal~lo~lgall cases offunctio!lal psychosis was found lo be 1.52%. Thcse patients had a later age of onset and were predo~nineotly ~uales when colllpnred to that reported for schizophrenia and i~cute ps'choscs. Pcrsccutory, somatic.ond jealous were the 111ost frequent subtypes. Sonlhticsubtype had an early'onset of illness when co~llpared to other subtypes.
Delusional disorder–jealous type: how inclusive are theDSM–IV diagnostic criteria?
Journal of Clinical Psychology, 2008
Delusional disorder–jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940–2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder–jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64: 1–12, 2008.
Clinical and Demographical Profiles of the Patients with Delusional Disorder: a Retrospective Study
Mustafa Kemal Üniversitesi Tıp Dergisi, 2019
Objective: We aimed to investigate demographic, environmental, psychosocial and clinical characteristics in a group of patients with delusional disorder (DD).Method: In a retrospective descriptive study design, cases with DD registered at Psychiatry Clinic of Xxxxxxx XxxxxxxResearch Hospital was conducted. We obtained a sample of 320 DD patients who met the inclusion criteria according to DSM-IV. Socio-demographic and general data, risk factors, clinical picture and diagnosis were collected.Results: Proportion of males versus females was of 1.12. Only 31.25% of patients were illiterate. Of the patients, 56.56% were married and about half of them shared home. About 16,9% of patients had a past history of alcohol consumption, and 2,3% consumed other drugs. The most frequent subtype with the persecutory with 158 cases (49.38%). Ideas of reference and of persecution were found in 83.75% and 81.88% respectively.Conclusions: We found a male preponderance and persecutory subtype with the m...
Clinical profile of delusional disorder and its subtypes: a descriptive study from Turkey
Rivista Di Psichiatria, 2021
The fact that delusional disorder (DD) received minimal research attention indicates the need for descriptive studies that will better delineate the clinical and socio-demographic characteristics of DD. We conducted a chart review descriptive study in a tertiary hospital from Turkey. A total of 99 cases of DD were identified through hospital registry system. 57 were male (57.6%), and mean age at first admission was 49.34±13.49. The most common type of DD was persecutory (36.4%), followed by jealous type (28.3%), mixed type (18.2%), and somatic type (16.2%). Jealous type DD patients were more likely to be married, and mixed type DD patients were more likely to be divorced. The presence of hallucinations was significantly associated with history of hospitalization. About one-tenth of the patients had a family history of psychotic spectrum disorder. Comorbid depressive disorder was present in 42.9% of the patients, whereas only 9.2% had comorbid anxiety disorder. Depressive disorder comorbidity in DD seems to be associated with continued treatment for longer periods of time in psychiatry services. While most of our data were comparable with the literature on DD, our divergent findings like higher rates of male patients and jealous type of the disorder might be attributed to the cultural and geographical factors. This situation points out that future research with larger populations and from different regions would contribute to better understanding of clinical and socio-demographical characteristics of delusional disorder.
Clinical schizophrenia & related psychoses, 2013
Background: Though hallucinations and delusions are prominent impairments in schizophrenia, epidemiological and neurobiological research reports of the relationship between hallucinatory and delusional disorders among schizophrenia patients are scant. Aims: To examine the epidemiological and clinical differences between hallucinatory and delusional subgroups of patients diagnosed with paranoid schizophrenia. Methods: One-hundred schizophrenia patients, paranoid type age 18-65 diagnosed between 1990-1995 were recruited and divided into Hallucinatory (H) and Delusional (D) subgroups. Demographic variables were compared. Schedules for the Assessment of Negative and Positive Symptoms (SANS, SAPS), Clinical Global Impression (CGI) were used for clinical assessments. Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-18) was used to assess quality of life. Results: Tendency for higher scores in the hallucinations subgroup on all scales and most variables. The hallucinations group had a broader range (in 43 of 78 variables 55.13%) and the delusions group had similar ranges of clinical evaluation scores (31 of 78 variables -39.74%).