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A case of delusional disorder

Published online by Cambridge University Press:  23 March 2020

O. Porta Olivares
Affiliation:
Hospital Universitario Marqués de Valdecilla, Usm López Albo, Santander, Spain
M. Juncal Ruiz
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Psychiatry, Santander, Spain
B. Fernández Abascal Puente
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Psychiatry, Santander, Spain
M. Gómez Revuelta
Affiliation:
Hospital Universitario de Álava, Inpatient Unit, Vitoria-Gasteiz, Spain
M. Pérez Herrera
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Psychiatry, Santander, Spain
J.L. Garcia Egea
Affiliation:
Hospital Universitario Virgen del Rocío, General Psychiatry, Sevilla, Spain
L. Garcia Ayala
Affiliation:
Hospital Universitario de Álava, General Psychiatry, Vitoria-Gasteiz, Spain
N.I. Nuñez Morales
Affiliation:
Hospital Universitario de Álava, General Psychiatry, Vitoria-Gasteiz, Spain
R. Landera Rodríguez
Affiliation:
Hospital Universitario Marqués de Valdecilla, Usm López Albo, Santander, Spain
G. Pardo de Santayana Jenaro
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Psychiatry, Santander, Spain
L. Sánchez Blanco
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Psychiatry, Santander, Spain

Abstract

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Introduction

Functioning of patients with delusional disorder may be impaired, particularly if the delusional thinking is chronic rather than episodic. They refuse to characterize their beliefs as false and view opposing views with surprise, if not hostility and disdain, dismissing or ignoring them, and continuing their struggle to find resolution or restitution for the wrongs they have endured or the illnesses from which they suffer. They typically reject and often resent the suggestion that they are mentally compromised. They are a difficult group to engage clinically, often refusing to meet with a clinician about their delusions and/or to take medication. The first-line treatment of delusional disorder is antipsychotic medication rather than other clinical interventions. Patients with the disorder often reject psychiatric treatment, it is particularly important that medication be prescribed in the context of a therapeutic relationship that includes support, education, encouragement of healthier pursuits, and discouragement of damaging, delusion-inspired actions.

Methods

We describe a case of a 55-year-old woman with a delusional disorder that was diagnosed 4 years before. The supervision of the right take of the treatment was not possible and the intensity of behavioral disturbances increased. Then we started the treatment with long-acting injectable aripiprazole.

Results

Within the 4 months following the start of treatment, her mental state improved by attenuation of psychotic symptoms.

Conclusions

Long-acting aripiprazole could be an effective tool for treatment of psychotic symptoms in patients with no insight and difficulties to check the proper treatment take.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Viewing: Schizophrenia and other psychotic disorders
Copyright
Copyright © European Psychiatric Association 2017
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