Delusional Disorder Flashcards
criterion A delusional disorder
presence of at least ONE DELUSION with a duration of at least ONE MONTH
criterion B delusional disorder
criterion A for schizophrenia has never been met
what if someone has hallucinations? can they be dx with delusional disorder?
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
criterion C delusional disorder
apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behaviour is not obviously bizarre or odd
criterion D delusional disorder
if manic or major depressive episodes have occurred, these have been BRIEF relative to the duration of the delusional episodes
criterion E delusional disorder
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
lifetime prevalence of delusional disorder
around 0.2%
what is the most frequent subtype of delusional disorder
persecutory
are there major gender differences in the overall frequency of delusional disorder
no
–> jealous type is probably more common in males than females
delusional disorder in late life increases the risk for what other disorders?
dementia and neurocognitive disorders
list risk factors for delusional disorder
immigration
isolation
family history
sensory impairment
advanced age
list the 8 possible specifiers of type of delusional disorder
erotomanic
grandiose
jealous
persecutory
somatic
mixed
unspecified
with bizarre content
when do you use the following specifier for delusional disorder:
erotomanic
when central theme of delusion is that another person is in love with the individual
when do you use the following specifier for delusional disorder:
grandiose
when central theme of the delusion is conviction of having some great but unrecognized talent or insight or having made some important discovery
when do you use the following specifier for delusional disorder:
jealous
when central theme of the delusion is that his or her spouse or lover is unfaithful
when do you use the following specifier for delusional disorder:
persecutory
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
when do you use the following specifier for delusional disorder:
mixed type
no one delusional theme predominates
when do you use the following specifier for delusional disorder:
somatic
central theme of delusion involves bodily functions or sensations
when do you use the following specifier for delusional disorder:
unspecified
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
when do you use the following specifier for delusional disorder:
with bizarre content
delusions deemed bizarre if they are clearly impausible, not understandable, and not derived from ordinary life
what are some treatment challenges with delusional disorder
highly resistant to treatment with medication alone
ddx delusional disorder
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
how do you rate severity in delusional disorder
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
*note that there are time specifiers that are only to be used after a 1 year duration of illness of the disorder
i.e first episode, currently in acute episode
how is insight impacted in delusional disorder
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
how do you rate severity in delusional disorder
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
*note that there are time specifiers that are only to be used after a 1 year duration of illness of the disorder
i.e first episode, currently in acute episode
how is insight impacted in delusional disorder
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
what is the development and course of delusional disorder
diagnosis is generally STABLE but some patients do go one to develop SCZ
global function is generally better than that observed in SCZ
what specifiers should be used when someone with OCD, or body dysmorphic disorder genuinely believes their beliefs are true?
i.e OCD with absent insight/delusional beliefs
or
body dysmorphic disorder with absent insight/delusional beliefs specifier.
(rather than dx delusional disorder)
