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Updated: Jul 28 2014

Delusional Disorder

Snap shot
  • A 25-year-old woman believes she the editor-in-chief of a famous magazine. She becomes irritated when pressed on specific details of how she got the job or if she can prove her employment. Collateral information reveals that she works as a waitress and has had no prior psychiatric history. No abnormalities are noted on mental status exam.
Introduction
  • Clinical definition
    • beliefs lasting > 1 month that are
      • fixed
      • non-bizarre
        • possible but highly unlikely
      • functioning is otherwise unimpaired
  • Associated conditions
    • shared psychotic disorder (folie à deux) 
      • when patient shares this delusion with another person
      • development of delusions in a person in a close relationship with someone with delusional disorder
      • often resolves upon separation, and it is important to interview separately to determine extent of delusions in each patient
Presentation
  • Symptoms
    • delusions
    • agitation
Treatment
  • Psychotherapy
  • Pharmacologic
    • atypical antipsychotic agents
Question
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