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.
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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]
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 atlas.
References24Show ledgerHide ledger
- [1]Kendler KS The nosologic validity of paranoia (simple delusional disorder). A review Arch Gen Psychiatry, 1980.PMID 7387341
- [2]Opjordsmoen S Delusional disorder as a partial psychosis Schizophr Bull, 2014.PMID 24421383
- [3]Skelton M, Khokhar WA, Thacker SP Treatments for delusional disorder Cochrane Database Syst Rev, 2015.PMID 25997589
- [4]Skelton M, Khokhar WA, Thacker SP Treatments for Delusional Disorder Schizophr Bull, 2015.PMID 26209547
- [5]Manschreck TC, Khan NL Recent advances in the treatment of delusional disorder Can J Psychiatry, 2006.PMID 16989110
- [6]Munro A, Mok H An overview of treatment in paranoia/delusional disorder Can J Psychiatry, 1995.PMID 8681259
- [7]González-Rodríguez A, Seeman MV Differences between delusional disorder and schizophrenia: A mini narrative review World J Psychiatry, 2022.PMID 35663297
- [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]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]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]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]Díaz-Caneja CM, Cervilla JA, Haro JM, et al. Cognition and functionality in delusional disorder Eur Psychiatry, 2019.PMID 30388425
- [13]Iannuzzi GL, Patel AA, Stewart JT Aripiprazole and Delusional Disorder J Psychiatr Pract, 2019.PMID 30849061
- [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]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]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]Howes OD, Kapur S The dopamine hypothesis of schizophrenia: version III--the final common pathway Schizophr Bull, 2009.PMID 19325164
- [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]Tandon R, Gaebel W, Barch DM, et al. Definition and description of schizophrenia in the DSM-5 Schizophr Res, 2013.PMID 23800613
- [20]Bebbington PE, McBride O, Steel C, et al. The structure of paranoia in the general population Br J Psychiatry, 2013.PMID 23661767
- [21]Cardno AG, McGuffin P Genetics and delusional disorder Behav Sci Law, 2006.PMID 16705657
- [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]Abdel-Hamid M, Brüne M Neuropsychological aspects of delusional disorder Curr Psychiatry Rep, 2008.PMID 18652791
- [24]Pellegrini R, Muñoz Negro JE, Ottoni R, et al. The Affective Core of Delusional Disorder Psychopathology, 2022.PMID 35272292