Delusional Diseases (original) (raw)
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International Journal of Environmental Research and Public Health
The theme, strength, and duration of a delusion are considered important in distinguishing one psychosis of old age from another. Research results, however, are mostly based on studies conducted on one form of psychosis, namely schizophrenia. The aim of this hypothesis-driven narrative review is to gather clinically important information about the psychosis identified as delusional disorder (DD), as it affects persons of senior age. We hypothesized that DD becomes relatively prevalent in old age, especially in women; and that it is associated with demonstrable brain changes, which, in turn, are associated with cognitive defects and poor pharmacological response, thus increasing the risk of aggression and suicide. Computerized searches in PubMed and ClinicalTrials.gov were conducted using the following search terms: (delusional disorder) AND (elderly OR old OR aged OR psychogeriatrics). A total of 16 recent studies (including case reports) were reviewed. Our hypotheses could not be d...
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.
A descriptive case-register study of delusional disorder
Data Revues 09249338 00230002 07014174, 2008
Objective. e A few empirically based studies' data on delusional disorder (DD) exist. We aim to describe sociodemographic and clinical correlates of DD and to identify clinical profiles associated to DD and its subtypes. Methods. e This is a case-register study based on all those subjects attending community mental health services within a geographically well-defined area. Four hundred and sixty-seven patients had been diagnosed as DD cases at psychiatric services serving a catchment area of some 607,494 inhabitants living in South Barcelona (Spain) during a three-year period (2001e2003). A thorough systematic review of computerised medical records was used to establish DSM-IV diagnosis, rendering a valid sample of 370 patients who fulfilled DSM-IV criteria for DD. Independent variables gathered include sociodemographic data, family and personal psychiatric history, and comorbid diagnoses on all DSM-IV axes (including GAF). We used descriptive and univariate statistical methods to explore sample frequencies and correlates across DD types. Results. e The mean age of the patients was 55 years and the sample had a mean GAF score of 51 suggesting a poor functionality; 56.5% of the patients were female. The most frequent DD types were persecutory (48%), jealous (11%), mixed (11%) and somatic (5%), whilst 23% qualified for the NOS type. Most frequent symptoms identified were self-reference (40%), irritability (30%), depressive mood (20%) and aggressiveness (15%). Hallucinations were present in 16% of the patients (6% tactile; 4% olfactory). Nearly 9% had a family history of schizophrenia (higher among those with the jealous subtype) and 42% had a comorbid axis II diagnosis (mostly paranoid personality disorder). Depression was significantly more frequent among the persecutory and jealous types. Finally, global functioning was significantly better among jealous and mixed types and worse amongst erotomanic and grandiose cases (p ¼ 0.008). Conclusions. e In the absence of other similar empirical data, this modest study provides unique empirical evidence of some clinical and risk correlates of DD and its subtypes.
Delusions in the general population: A systematic review with emphasis on methodology
Schizophrenia Research, 2019
The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and comprehension is a matter of continuing debate. In recent years studies showing that delusions are common in the general population have accumulated and challenged the way we perceive psychotic illness. In this systematic review, we examine the basis of the psychosis continuum-hypothesis, by reviewing a representative section of the original literature that report measures of delusional ideation in the general population, focusing specifically on methodology. Three online databases were systematically searched for relevant studies. After applying criteria of inclusion and exclusion, 17 articles were included for comprehensive review. Estimates of the distribution of delusions in the general population vary substantially, as does the mode of assessment. The methodology relies with few exceptions exclusively on self-report and fully structured interview by lay person. We conclude that measures of delusions in the general population should be interpreted cautiously due to inherent difficulties in methodology. Hypothesizing a continuum of delusion between normality and full-blown psychosis is deemed premature based on the reviewed studies.
Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review
Frontiers in Integrative Neuroscience, 2022
Delusions are marked, fixed beliefs that are incongruent with reality. Delusions, with comorbid hallucinations, are a hallmark of certain psychotic disorders (e.g., schizophrenia). Delusions can present transdiagnostically, in neurodegenerative (e.g., Alzheimer's disease and fronto-temporal dementia), nervous system disorders (e.g., Parkinson's disease) and across other psychiatric disorders (e.g., bipolar disorder). The burden of delusions is severe and understanding the heterogeneity of delusions may delineate a more valid nosology of not only psychiatric disorders but also neurodegenerative and nervous system disorders. We systematically reviewed structural neuroimaging studies reporting on delusions in four disorder types [schizophrenia (SZ), bipolar disorder (BP), Alzheimer's disease (AD), and Parkinson's disease (PD)] to provide a comprehensive overview of neural changes and clinical presentations associated with delusions. Twenty-eight eligible studies were id...
Persistent delusional disorder in a 32 year old male
Highland Medical Research Journal, 2015
Background : Persistent delusional disorder is a permanent, unshakable and encapsulated delusional system, developing insidiously in middle or late life with no impairment in other mental functions. This paper reviews a case of persistent delusional disorder. Methods : The case record of a 32 year old man who said nothing was wrong with him but whose wife said he has been suspicious that several people around him were planning to harm him was reviewed. Results : The long history of his suspiciousness of several people despite no evidence that anyone is planning to harm him, lack of evidence of an organic mental disorder or the use of alcohol or drugs, the criteria for schizophrenia was not fulfilled, the preservation of other mental functions in this patient, his ability to continue to function effectively and his lack of insight conform to the ICD 10 diagnosis of persistent delusional disorder (persecutory type). Conclusion : Cases of persistent delusional disorder (persecutory typ...
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.
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...