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Delusional Disorders

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The Medical Basis of Psychiatry

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Abstract

Delusional disorders are characterized by delusions in the absence of any other psychiatric illness that could account for the delusional thought processes. DSM-IV lists erotomanic, grandiose, jealous, persecutory, and somatic subtypes. The prevalence of delusional disorders has been estimated to be 24 to 30 cases per 100,000 people, and their annual incidence to be 0.7 to 3.0 new cases per 100,000 people. The available evidence does not suggest a shared predisposition with either schizophrenia or mood disorders. Although the neuropathology of delusional disorders is unknown, there is some evidence suggesting enlarged ventricles and eye-tracking abnormalities. The course of the illness is highly variable; some patients recover rapidly and completely but, in other patients, the illness runs a chronic course. Conditions to be excluded before diagnosing a delusional disorder include paranoid schizophrenia, psychotic mood disorder, dementia, drug-induced psychotic disorder, paranoid personality disorder, and hypochondriasis. Pimozide has been the preferred antipsychotic agent for delusional disorders, particularly the somatic subtype, but, in recent years, there has been a steady trend toward treating delusional disorders with second-generation antipsychotic agents. Some therapists are now using cognitive–behavioral therapy in these patients as well.

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Authors
  1. Raymond R. Crowe MD
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  2. Marc-Andre Roy MD
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Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Minnesota Medical School Medicine, 420 Delaware Street, SE Minneapolis, MN 55455, USA

    S. Hossein Fatemi PhD

  2. American Foundation for Suicide Prevention, 120 Wall Street, New York, NY 10005, USA

    Paula J. Clayton MD (Medical Director) (Medical Director)

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Crowe, R.R., Roy, MA. (2008). Delusional Disorders. In: Fatemi, S.H., Clayton, P.J. (eds) The Medical Basis of Psychiatry. Humana Press. https://doi.org/10.1007/978-1-59745-252-6_8

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  • DOI: https://doi.org/10.1007/978-1-59745-252-6_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-917-8

  • Online ISBN: 978-1-59745-252-6

  • eBook Packages: MedicineMedicine (R0)

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