Delusional Disorder

Question 1

criterion A delusional disorder

Answer 1

presence of at least ONE DELUSION with a duration of at least ONE MONTH

Question 2

criterion B delusional disorder

Answer 2

criterion A for schizophrenia has never been met

Question 3

what if someone has hallucinations? can they be dx with delusional disorder?

Answer 3

hallucinations, if present, are NOT prominent and are related to the delusional theme i.e sensation of being infested with insects associated with delusions of infestation

Question 4

criterion C delusional disorder

Answer 4

apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behaviour is not obviously bizarre or odd

Question 5

criterion D delusional disorder

Answer 5

if manic or major depressive episodes have occurred, these have been BRIEF relative to the duration of the delusional episodes

Question 6

criterion E delusional disorder

Answer 6

disturbance not attributable to the physiological effects of a substance or another medical condition

not better explained by another mental disorder such as body dysmorphic disorder or OCD

Question 7

lifetime prevalence of delusional disorder

Answer 7

around 0.2%

Question 8

what is the most frequent subtype of delusional disorder

Answer 8

persecutory

Question 9

are there major gender differences in the overall frequency of delusional disorder

Answer 9

no

–> jealous type is probably more common in males than females

Question 10

delusional disorder in late life increases the risk for what other disorders?

Answer 10

dementia and neurocognitive disorders

Question 11

list risk factors for delusional disorder

Answer 11

immigration

isolation

family history

sensory impairment

advanced age

Question 12

list the 8 possible specifiers of type of delusional disorder

Answer 12

erotomanic

grandiose

jealous

persecutory

somatic

mixed

unspecified

with bizarre content

Question 13

when do you use the following specifier for delusional disorder:

erotomanic

Answer 13

when central theme of delusion is that another person is in love with the individual

Question 14

when do you use the following specifier for delusional disorder:

grandiose

Answer 14

when central theme of the delusion is conviction of having some great but unrecognized talent or insight or having made some important discovery

Question 15

when do you use the following specifier for delusional disorder:

jealous

Answer 15

when central theme of the delusion is that his or her spouse or lover is unfaithful

Question 16

when do you use the following specifier for delusional disorder:

persecutory

Answer 16

central theme of delusion involves belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harrassed or obstructed in the pursuit of long term goals

Question 17

when do you use the following specifier for delusional disorder:

mixed type

Answer 17

no one delusional theme predominates

Question 18

when do you use the following specifier for delusional disorder:

somatic

Answer 18

central theme of delusion involves bodily functions or sensations

Question 19

when do you use the following specifier for delusional disorder:

unspecified

Answer 19

the dominant delusional belief cannot be clearly determined or is not described in the subtypes i.e referential delusions without prominent persecutory or grandiose component

Question 20

when do you use the following specifier for delusional disorder:

with bizarre content

Answer 20

delusions deemed bizarre if they are clearly impausible, not understandable, and not derived from ordinary life

Question 21

what are some treatment challenges with delusional disorder

Answer 21

highly resistant to treatment with medication alone

Question 22

ddx delusional disorder

Answer 22

CNS neoplasms

OCD and related

delirium

major NCD

psychotic disorder due to another medical condition

substance induced psychotic disorder

schizophrenia and schizophreniform disorder

depressive or bipolar disorders

schizoaffective disorder

Question 23

how do you rate severity in delusional disorder

Answer 23

rated by a quantitative assessment of the primary symptoms of psychosis –> each rated for current severity (most severe in the last 7 days) on 5 point scale ranging from 0 (not present) to 4 (present and severe)

*can make dx without using this severity specifier

Question 24

*note that there are time specifiers that are only to be used after a 1 year duration of illness of the disorder

Answer 24

i.e first episode, currently in acute episode

Question 25

how is insight impacted in delusional disorder

Answer 25

may have “factual insight” but no true insight

i.e may be able to factually describe that others view their beliefs as irrational but are unable to accept it themsevles

Question 26

how do you rate severity in delusional disorder

Answer 26

rated by a quantitative assessment of the primary symptoms of psychosis –> each rated for current severity (most severe in the last 7 days) on 5 point scale ranging from 0 (not present) to 4 (present and severe)

*can make dx without using this severity specifier

Question 27

*note that there are time specifiers that are only to be used after a 1 year duration of illness of the disorder

Answer 27

i.e first episode, currently in acute episode

Question 28

how is insight impacted in delusional disorder

Answer 28

may have “factual insight” but no true insight

i.e may be able to factually describe that others view their beliefs as irrational but are unable to accept it themsevles

Question 29

what is the development and course of delusional disorder

Answer 29

diagnosis is generally STABLE but some patients do go one to develop SCZ

global function is generally better than that observed in SCZ

Question 30

what specifiers should be used when someone with OCD, or body dysmorphic disorder genuinely believes their beliefs are true?

Answer 30

i.e OCD with absent insight/delusional beliefs

or

body dysmorphic disorder with absent insight/delusional beliefs specifier.

(rather than dx delusional disorder)