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Vexatious litigant vs paranoia querulans: A systematic review

Published online by Cambridge University Press:  13 August 2021

J. Pinzón-Espinosa ,
A. González-Rodríguez ,
A. Guàrdia ,
M. Betriu Sabaté ,
P. Manozzo-Hernandez ,
A. Alvarez Pedrero ,
S. Acebillo ,
J. Labad  and
D. Palao Vidal
J. Pinzón-Espinosa*
Affiliation:
Salut Mental Taulí, Parc Taulí Hospital Universitari, Sabadell, Spain Department Of Clinical Psychiatry, School of Medicine, University of Panama, Panama City, Panama Department Of Medicine, School of Medicine, University of Barcelona, Barcelona, Spain
A. González-Rodríguez
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT. CIBERSAM, Sabadell, Spain
A. Guàrdia
Affiliation:
Mental Health, Parc Taulí-University Hospital, Sabadell, Spain
M. Betriu Sabaté
Affiliation:
Mental Health, Parc Tauli University Hospital, Sabadell, Spain
P. Manozzo-Hernandez
Affiliation:
Mental Health, Parc Taulí-University Hospital, Sabadell, Spain
A. Alvarez Pedrero
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
S. Acebillo
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
J. Labad
Affiliation:
Mental Health, Hospital of Mataró. Consorci Sanitari del Maresme. CIBERSAM., Mataró, Spain
D. Palao Vidal
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT. CIBERSAM, Sabadell, Spain
*
*Corresponding author.

Abstract

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Introduction

Paranoia querulans is a type of persistent delusional disorder of the persecutory subtype, recognized under ICD-10 and DSM-IV. Being a classically described entity, evidence is lacking from its conceptualization as a nosological entity to diagnosis and treatment. Furthermore, controversy still exists regarding its interplay between the judicial and mental health systems.

Objectives

To summarize current evidence and knowledge regarding Paranoia querulans on its conceptualization, ethiopathological explanations, therapeutical management and interface between psychiatry and the law.

Methods

A systematic review was undertaken between June and October 2020 in the PubMed, Web of Science and Scopus databases according to PRISMA directive. Key-terms: ((querul* OR vexatious) AND (paranoia OR delusio* OR neuros* OR behavi* OR complai*) OR litig*) AND psychiatry. No language or time restrictions were established.

Results

A total of 1648 studies were initially identified (PubMed: 679; WOS: 945; Scopus: 24; other: 0); after duplicates were removed, n=1381 studies remained. After screening title and abstract, 56 studies were included. Their main content was categorized into: 1. Conceptualization (n=26): Neurosis (n=5), psychosis (n=9), behavioral disorder (n=5); no psychiatric diagnosis (n=7). 2. Descriptive psychopathology (n=8) 3. Etiopathogenesis (n=9): Social or personality basis (n=3), culture (n=4), trauma (n=1), cognitive decline (n=1) 4. Management (n=1) 5. Psychiatry and Law: same object, different objectives (n=12)

Conclusions

There is controversy regarding the nosological entity of querulousness, from psychosis to neurosis or behavioral disorders. Some authors consider this behavior to not be a psychiatric diagnosis. Furthermore, most papers dealt with a social or nurture-based origin. There is a dearth of information regarding treatment.

Conflict of interest

JPE has received CME-related fees from Lundbeck.

Keywords

Paranoia querulansVexatious litigantPsychiatry and LawDelusional disorder
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S381 - S382
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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