Skip to main content
MedVellum
QuestionsVideosPricing

MedVellum

Fellowship exam preparation across every specialty: source-verified topics, questions in every format, and videos.

Product

  • Specialties
  • Questions
  • Videos
  • Exam tools
  • Pricing

Verification & policy

  • Verified register
  • Editorial policy
  • Privacy
  • Terms

Account

  • Sign in
  • Create account
  • Dashboard
  • Account & billing

© 2026 MedVellum. For education only — not a substitute for clinical judgement.

llms.txtPsychiatry LLM catalogSitemap

Psych TopicsGeneral adult psychiatry — psychotic disorders

Psych · General adult psychiatry — psychotic disorders

Delusional disorder

Also known as Paranoia · Persistent delusional disorder · Simple delusional disorder · Othello syndrome · de Clérambault syndrome · Paranoid disorder

Exam-exhaustive fellowship reference on delusional disorder — DSM-5-TR and ICD-11 criteria; subtypes (persecutory, jealous, erotomanic, somatic, grandiose); discrimination from schizophrenia and mood psychosis; engagement without collusion; limited RCT evidence for antipsychotics (Cochrane); risk by subtype; late-life care; RANZCP/APA-oriented guidance. FRANZCP-primary, globally tagged.

medium24 referencesUpdated 25 July 202611 min readVerification in progress

Practise this topic

  • 10 MCQs

Your progress

Saved on this device.

Practise this topic10 MCQs with explanations

Target exams

FRANZCPMRCPsychABPNMD-DNBNEET-SS

Red flags

  • Jealous (Othello) delusion with partner monitoring, weapons, or planned confrontation — treat as high domestic-violence risk until proven otherwise
  • Persecutory acting-on-belief (pre-emptive strike against 'enemies') — same-day risk review, means restriction, legal status
  • Erotomanic pursuit/stalking of a named person — multi-agency safety planning
  • Somatic subtype seeking self-surgery or endless invasive procedures — protect from iatrogenic harm while excluding genuine pathology
  • New late-life fixed belief with cognitive plunge or focal neurology — do not lock a primary delusional-disorder label until organic work-up
  • Colluding with the delusion or humiliating frontal challenge — both destroy alliance and increase disengagement risk
On this page
Study tools

Your progress

Saved on this device.

Practise this topic10 MCQs with explanations

Target exams

FRANZCPMRCPsychABPNMD-DNBNEET-SS

Red flags

  • Jealous (Othello) delusion with partner monitoring, weapons, or planned confrontation — treat as high domestic-violence risk until proven otherwise
  • Persecutory acting-on-belief (pre-emptive strike against 'enemies') — same-day risk review, means restriction, legal status
  • Erotomanic pursuit/stalking of a named person — multi-agency safety planning
  • Somatic subtype seeking self-surgery or endless invasive procedures — protect from iatrogenic harm while excluding genuine pathology
  • New late-life fixed belief with cognitive plunge or focal neurology — do not lock a primary delusional-disorder label until organic work-up
  • Colluding with the delusion or humiliating frontal challenge — both destroy alliance and increase disengagement risk
One-line fellowship answer

Delusional disorder is a partial psychosis: one or more delusions lasting at least 1 month without the full schizophrenia syndrome, with functioning often relatively preserved outside the delusional theme. Management is alliance-first engagement, subtype-specific risk work (jealous and persecutory above all), a carefully offered antipsychotic despite sparse DD-specific RCTs, and cognitive and psychosocial approaches that target distress and behaviour rather than forced belief surrender.[2][3][7][15]

Meet the patient

A 52-year-old accountant is brought in by his wife. For eight months he has known — known — that she is unfaithful. He has checked her phone, installed a camera in the hallway, and started following her on Saturdays. His work is intact; his colleagues notice nothing. Last night he told his brother he would "rather end it than be made a fool of." She is terrified, and she cannot say of what, exactly.[2][7]

The examiner's question is not "is the belief true?" It is: "Name the subtype, name the risk, and tell me your next move." This topic is that answer.[7][15]

Psychiatry Fellowship Pro

Continue reading

You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship library.

Sign in to continueSee pricing
References24ShowHide
  1. [1]Kendler KS The nosologic validity of paranoia (simple delusional disorder). A review Arch Gen Psychiatry, 1980.PMID 7387341
  2. [2]Opjordsmoen S Delusional disorder as a partial psychosis Schizophr Bull, 2014.PMID 24421383
  3. [3]Skelton M, Khokhar WA, Thacker SP Treatments for delusional disorder Cochrane Database Syst Rev, 2015.PMID 25997589
  4. [4]Skelton M, Khokhar WA, Thacker SP Treatments for Delusional Disorder Schizophr Bull, 2015.PMID 26209547
  5. [5]Manschreck TC, Khan NL Recent advances in the treatment of delusional disorder Can J Psychiatry, 2006.PMID 16989110
  6. [6]Munro A, Mok H An overview of treatment in paranoia/delusional disorder Can J Psychiatry, 1995.PMID 8681259
  7. [7]González-Rodríguez A, Seeman MV Differences between delusional disorder and schizophrenia: A mini narrative review World J Psychiatry, 2022.PMID 35663297
  8. [8]González-Rodríguez A, Monreal JA, Natividad M, et al. Seventy Years of Treating Delusional Disorder with Antipsychotics: A Historical Perspective Biomedicines, 2022.PMID 36552037
  9. [9]González-Rodríguez A, Seeman MV, Izquierdo E, et al. Delusional Disorder in Old Age: A Hypothesis-Driven Review of Recent Work Focusing on Epidemiology, Clinical Aspects, and Outcomes Int J Environ Res Public Health, 2022.PMID 35805570
  10. [10]Muñoz-Negro JE, Ibáñez-Casas I, de Portugal E, et al. A Psychopathological Comparison between Delusional Disorder and Schizophrenia Can J Psychiatry, 2018.PMID 28595494
  11. [11]Muñoz-Negro JE, Ibanez-Casas I, de Portugal E, et al. A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder Schizophr Res, 2015.PMID 26585220
  12. [12]Díaz-Caneja CM, Cervilla JA, Haro JM, et al. Cognition and functionality in delusional disorder Eur Psychiatry, 2019.PMID 30388425
  13. [13]Iannuzzi GL, Patel AA, Stewart JT Aripiprazole and Delusional Disorder J Psychiatr Pract, 2019.PMID 30849061
  14. [14]Perälä J, Suvisaari J, Saarni SI, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population Arch Gen Psychiatry, 2007.PMID 17199051
  15. [15]Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Aust N Z J Psychiatry, 2016.PMID 27106681
  16. [16]Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia Am J Psychiatry, 2020.PMID 32867516
  17. [17]Howes OD, Kapur S The dopamine hypothesis of schizophrenia: version III--the final common pathway Schizophr Bull, 2009.PMID 19325164
  18. [18]Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis Lancet, 2013.PMID 23810019
  19. [19]Tandon R, Gaebel W, Barch DM, et al. Definition and description of schizophrenia in the DSM-5 Schizophr Res, 2013.PMID 23800613
  20. [20]Bebbington PE, McBride O, Steel C, et al. The structure of paranoia in the general population Br J Psychiatry, 2013.PMID 23661767
  21. [21]Cardno AG, McGuffin P Genetics and delusional disorder Behav Sci Law, 2006.PMID 16705657
  22. [22]de Portugal E, Díaz-Caneja CM, González-Molinier M, et al. Prevalence of premorbid personality disorder and its clinical correlates in patients with delusional disorder Psychiatry Res, 2013.PMID 23993136
  23. [23]Abdel-Hamid M, Brüne M Neuropsychological aspects of delusional disorder Curr Psychiatry Rep, 2008.PMID 18652791
  24. [24]Pellegrini R, Muñoz Negro JE, Ottoni R, et al. The Affective Core of Delusional Disorder Psychopathology, 2022.PMID 35272292

Test yourself

Practise what you just read

  • 10 MCQs
Psychiatry Fellowship Pro

$29/ monthor $279 / year

The complete Psychiatry Fellowship library, every exam format, one subscription.

  • Complete library for one chosen specialty
  • Timed MCQ mock exams and spaced review
  • Clinical cases & cross-table vivas
See pricingSign in
PreviousDelirium in older adultsOld age psychiatry — delirium and acute cognitive syndromesNextSchizoaffective disorderGeneral adult psychiatry — psychotic disorders