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Two Case Studies of Delusions Leading to Suicide, a Selective Review

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Abstract

Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to treat with antidepressants, cognitive therapy, or antipsychotic medication. DD is associated with psychiatric comorbidity, especially depression, and rates of suicidal behavior are high when the two conditions co-exist. In this selective review, we present two instances of suicide in the context of DD, one illustrating risks for the somatic subtype and the second, risks for the persecutory subtype. The frequency of suicidal behaviour in these two subtypes of DD is estimated at 8–21%. The literature suggests a prominent role for social emotions (shame, humiliation) in the pathway leading to suicide. In addition, risk factors found in our two patients point to factors such as poverty, living alone, vulnerable risk periods, stigma, and lack of trust in mental health services. Building trust may be the most effective preventive measure.

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Authors and Affiliations

  1. Department of Mental Health, Parc Tauli University Hospital. I3PT. Autonomous University of Barcelona (UAB), Sabadell, Barcelona, Spain

    Alexandre González-Rodríguez

  2. Department of Psychiatry, University of Toronto, 260 Heath Street West, Suite #605, Toronto, ON, M5P 3L6, Canada

    Mary V. Seeman

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  1. Alexandre González-Rodríguez
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Contributions

Each author provided one case and they equally contributed to the research and writing of the manuscript.7.

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Correspondence to Mary V. Seeman.

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AGR received travels costs and registration for congresses from Janssen, Lundbeck-Otsuka and Angelini. There are no competing interests.

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The case analyses are retrospective and anonymized. All potentially identifiable facts have been altered. The Research Ethics Committees of our two hospitals do not require committee approval for case studies as long as the persons involved are not identifiable.

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González-Rodríguez, A., Seeman, M.V. Two Case Studies of Delusions Leading to Suicide, a Selective Review. Psychiatr Q 91, 1061–1073 (2020). https://doi.org/10.1007/s11126-020-09802-w

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