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A descriptive case-register study of delusional disorder

Published online by Cambridge University Press:  16 April 2020

Enrique de Portugal ,
Nieves González ,
Josep M. Haro ,
Jaume Autonell  and
Jorge A. Cervilla
Enrique de Portugal
Affiliation:
Department of Psychiatry, Hospital Gregorio Marañon, Madrid, Spain
Nieves González
Affiliation:
Research and Development Unit, Sant Joan de Déu-SSM, Barcelona, Spain
Josep M. Haro
Affiliation:
Research and Development Unit, Sant Joan de Déu-SSM, Barcelona, Spain
Jaume Autonell
Affiliation:
Research and Development Unit, Sant Joan de Déu-SSM, Barcelona, Spain
Jorge A. Cervilla*
Affiliation:
Research and Development Unit, Sant Joan de Déu-SSM, Barcelona, Spain Department of Psychiatry and Institute of Neurosciences, University of Granada, Spain
*
*Corresponding author. Department of Psychiatry and Institute of Neurosciences, Faculty of Medicine, University of Granada, Avenida de Madrid 11, 18012 Granada, Andalucia, Spain. Tel./fax: +34958242017. E-mail address: [email protected] (J.A. Cervilla).
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Abstract

Objective

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

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 (2001–2003). 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

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 = 0.008).

Conclusions

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.

Keywords

Delusional disorderDelusionsPsychotic symptomsPsychopathologyPsychosisParanoia
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 2 , March 2008 , pp. 125 - 133
Copyright
Copyright © Elsevier Masson SAS 2008

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References

American Psychiatry Association, Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: American Psychiatry Association; 1994.Google Scholar
Autonell, J., Mochón, F.Historia Clínica informática y redes asistenciales en salud mental. Available from: http://www.psiquiatria.com/interpsiquis2002/6249.Google Scholar
Bömer, I., Brüne, M.Social cognition in “pure” delusional disorder. Cognit Neuropsychiatry 2006;11(5):493–503.CrossRefGoogle Scholar
Cardno, A.G., Rijsdij, F.V., Sham, P.C., Murray, R.M., McGuffin, P.A twin study of genetic relationships between psychotic symptoms. Am J Psychiatry 2002;159:539–545.CrossRefGoogle ScholarPubMed
Cooper, A.F., Garcide, R.F., Kay, D.W.K.A comparison of the deaf and non deaf patients with paranoids and affective psychoses. Br J Psychiatry 1976;129:532.CrossRefGoogle Scholar
Cooper, A.F., Kay, D.W.K., Curry, A.R.Hearing loss in paranoid and affective psychoses of the elderly. Lancet 1974;2:851–854.CrossRefGoogle ScholarPubMed
Debanath, M., Das, S.K., Bera, N.K., Nayak, C.R., Chaudhuri, T.K.Genetic associations between delusional disorder and paranoid schizophrenia: a novel etiologic approach. Can J Psychiatry 2006;51:342–349.CrossRefGoogle Scholar
Eastwood, R., Corbin, S., Reed, M.Hearing impairment and paraphrenia. J Otolaryngol 1981;10:306–308.Google ScholarPubMed
Enoch, D., Ball, H.The Othello syndrome. In: Enoch, D., Ball, H., editors.Uncommon psychiatric syndromes 4th ed.London: Arnold; 2001. p. 50–73.Google Scholar
Gottesman, I., Irving, I.Schizophrenia genesis: the origin of madness. New York; Oxford: WH Freeman; 1991. p. 203.Google Scholar
Hitch, P., Rack, P.Mental illness among Polish and Russian refugees in Bradford. Br J Psychiatry 1980;137:206–211.CrossRefGoogle Scholar
Hsiao, M.C., Liu, C.Y., Yang, Y.Y., Yeh, E.K.Delusional disorder: retrospective analysis of 86 Chinese outpatients. Psychiatry Clin Neurosci 1999;53:673–676.CrossRefGoogle ScholarPubMed
Jimenez, D., Chinchilla, A.Personality disorders in a psychiatric unit: retrospective study. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1995;23:58–66.Google Scholar
Kendler, K.S., Gruenberg, A.M., Strauss, J.S.An independent analysis of the Copenhagen sample of the Danish adoption study of schizophrenia III: the relationship between paranoid psychosis (delusional disorder) and the schizophrenia spectrum disorder. Arch Gen Psychiatry 1981;38:985–987.CrossRefGoogle Scholar
Kendler, K.S., Gruenberg, A.M., Tsuang, M.T.Psychiatric illness in first degree relatives of schizophrenia and surgical control patients: a family study using DSM-III criteria. Arch Gen Psychiatry 1985;42:770–779.CrossRefGoogle ScholarPubMed
Kendler, K.S., Gruenberg, A.M.Genetic relationship between paranoid personality disorder and the “schizophrenic spectrum” disorders. Am J Psychiatry 1982;139:1185–1187.Google ScholarPubMed
Kendler, K.S., Hays, P.Paranoid psychosis (delusional disorder) and schizophrenia: a family history study. Arch Gen Psychiatry 1981;38:547–551.CrossRefGoogle ScholarPubMed
Kendler, K.S., Masterson, C.C., Ungaro, R.A family history study of schizophrenia-related personality disorder. Am J Psychiatry 1984;141:424–427.Google Scholar
Kendler, K.S., Walsh, D.Schizophreniform disorder delusional disorder and psychotic disorder not otherwise specified: clinical features outcome and familial psychopathy. Acta Psychiatr Scand 1995;9:370–378.CrossRefGoogle Scholar
Kendler, K.S.Demography of paranoid psychosis (delusional disorder): a review and comparison with schizophrenia and affective illness. Arch Gen Psychiatry 1982;39:890–902.CrossRefGoogle ScholarPubMed
Maina, G., Albert, U., Bada, A., Bogetto, F.Occurrence and clinical correlates of psychiatric co-morbidity in delusional disorder. Eur Psychiatry 2001;16:222–228.CrossRefGoogle ScholarPubMed
Marino, C., Nobile, M., Bellodi, L., Smeraldi, E.Delusional disorder and mood disorder: can they coexist. Psychopathology 1993;26:58–61.CrossRefGoogle ScholarPubMed
Munro, A.A delusional hypochondriasis. Clarke Institute of Psychiatry monograph no. 5 Toronto: Clarke Institute of Psychiatry; 1982.Google Scholar
Munro, A.Delusional disorder. Cambridge University Press; 1999.CrossRefGoogle Scholar
Serretti, A., Lattuada, E., Cusin, C., Smeraldi, E.Factor analysis of delusional disorder symptomatology. Compr Psychiatry 1999;40:143–147.CrossRefGoogle ScholarPubMed
Soni, S.Relationship between peripheral sensory disturbances and onset of symptoms in elderly paraphrenics. Int J Geriatr Psychiatry 1988;3:275–279.CrossRefGoogle Scholar
Vauhkonen, K.On pathogenesis of morbid jealousy - with special reference to personality traits of and interaction between jealous patients and their spouses. Acta Psychiatr Scand 1968;46:1–62.Google Scholar
Watt, J.A.G., Hall, D.J., Olley, P.C.Paranoids states of middle life. Familiar occurrence and relationship to schizophrenia. Acta Psychiatr Scand 1980;61:413–426.CrossRefGoogle Scholar
Watt, J.A.G.The relationship of paranoid states to schizophrenia. Am J Psychiatry 1985;142:1456–1458.Google Scholar
Winokur, G.Familial psychopathology in delusional disorder. Compr Psychiatry 1985;26:241–248.CrossRefGoogle ScholarPubMed
Yamada, N., Nakajima, S., Noguchi, T.Age onset of delusional disorder is dependent on the delusional theme. Acta Psychiatr Scand 1998;97:122–124.CrossRefGoogle ScholarPubMed
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