Delusional disorder history and symptoms: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
*The presence of non-bizarre delusions is the most obvious symptom of this disorder. Other symptoms include the following:<ref name="pmid8626368">{{cite journal| author=Manschreck TC| title=Delusional disorder: the recognition and management of paranoia. | journal=J Clin Psychiatry | year= 1996 | volume= 57 Suppl 3 | issue= | pages= 32-8; discussion 49 | pmid=8626368 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8626368 }} </ref><ref name="pmid18082379">{{cite journal| author=de Portugal E, González N, Haro JM, Autonell J, Cervilla JA| title=A descriptive case-register study of delusional disorder. | journal=Eur Psychiatry | year= 2008 | volume= 23 | issue= 2 | pages= 125-33 | pmid=18082379 | doi=10.1016/j.eurpsy.2007.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18082379 }} </ref> | *The presence of non-bizarre delusions is the most obvious symptom of this disorder. | ||
*Self-reference | *Other symptoms include the following:<ref name="pmid8626368">{{cite journal| author=Manschreck TC| title=Delusional disorder: the recognition and management of paranoia. | journal=J Clin Psychiatry | year= 1996 | volume= 57 Suppl 3 | issue= | pages= 32-8; discussion 49 | pmid=8626368 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8626368 }} </ref><ref name="pmid18082379">{{cite journal| author=de Portugal E, González N, Haro JM, Autonell J, Cervilla JA| title=A descriptive case-register study of delusional disorder. | journal=Eur Psychiatry | year= 2008 | volume= 23 | issue= 2 | pages= 125-33 | pmid=18082379 | doi=10.1016/j.eurpsy.2007.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18082379 }} </ref> | ||
*An irritable, angry, or low mood. Mild dysphoria may be present without regard of type of delusions. Mood and affect are consistent with delusional content: for example, patients with persecutory delusions may be suspicious and anxious. | **Self-reference | ||
*Agressiveness | **An irritable, angry, or low mood. Mild dysphoria may be present without regard of type of delusions. Mood and affect are consistent with delusional content: for example, patients with persecutory delusions may be suspicious and anxious. | ||
***Agressiveness | |||
*Tactile and olfactory hallucinations may be present. Hallucinations are related to the delusion.<ref name="pmid23719328">{{cite journal| author=Ramos N, Wystrach C, Bolton M, Shaywitz J, IsHak WW| title=Delusional disorder, somatic type: olfactory reference syndrome in a patient with delusional trimethylaminuria. | journal=J Nerv Ment Dis | year= 2013 | volume= 201 | issue= 6 | pages= 537-8 | pmid=23719328 | doi=10.1097/NMD.0b013e31829482fd | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23719328 }} </ref> | *Tactile and olfactory hallucinations may be present. Hallucinations are related to the delusion.<ref name="pmid23719328">{{cite journal| author=Ramos N, Wystrach C, Bolton M, Shaywitz J, IsHak WW| title=Delusional disorder, somatic type: olfactory reference syndrome in a patient with delusional trimethylaminuria. | journal=J Nerv Ment Dis | year= 2013 | volume= 201 | issue= 6 | pages= 537-8 | pmid=23719328 | doi=10.1097/NMD.0b013e31829482fd | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23719328 }} </ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 07:18, 4 December 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
The hallmark of delusional disorder is non-bizarre delusions. A positive history of irritable, angry, or low mood and hallucinations that are related to the delusion is suggestive of delusional disorder.
History
- Interviews are important tools to obtain information about the patient's life situation and past history to help make a diagnosis. Clinicians generally review earlier medical records to gather a full history. Clinicians also try to interview the patient's immediate family, as this can be helpful in determining the presence of delusions.[1]
- A detailed psychiatric history and exam can be used to distinguish delusional disorder from other mental disorders. A complete medical history, physical examination, and laboratory testing are used to rule out medical causes of psychosis. As delusional disorder is uncommon and it possesses some characteristics of the full range of paranoid illness, it is clearly a diagnosis of exclusion. A thorough history, mental status examination, and radiologic/laboratory evaluation should be performed to rule out other medical and psychiatric conditions that are commonly present with delusions.
- The clinical assessment of paranoid features requires the following three steps:[2]
- Firstly the clinician must recognize, characterize, and judge as pathological the presenting paranoid features.
- Secondly, the clinician must determine whether the paranoid features form a part of a syndrome or are isolated.
- Thirdly and finally, the differential diagnosis should be developed. CNS illness is high on the differential diagnosis of any psychotic disorder, especially so in the onset of delusional disorder in patients older than the typical onset of schizophrenia. Delusional disorder should be seen as a diagnosis of exclusion. Differential diagnosis includes ruling out other causes such as dememtia, metabolic disorders, drug-induced conditions, infections, and endocrine disorders. Other psychiatric disorders must then be ruled out. In delusional disorder, mood symptoms tend to be brief or absent, and unlike schizophrenia, delusions are non-bizarre and hallucinations are minimal or absent. Differential diagnosis of delusional disorder can be found here
Symptoms
- The presence of non-bizarre delusions is the most obvious symptom of this disorder.
- Other symptoms include the following:[3][4]
- Self-reference
- An irritable, angry, or low mood. Mild dysphoria may be present without regard of type of delusions. Mood and affect are consistent with delusional content: for example, patients with persecutory delusions may be suspicious and anxious.
- Agressiveness
- Tactile and olfactory hallucinations may be present. Hallucinations are related to the delusion.[5]
References
- ↑ Delusional disorder. Wikipedia(2015) https://en.wikipedia.org/wiki/Delusional_disorder#Causes Accessed on November 8, 2015
- ↑ Grover, Sandeep, Nitin Gupta, and Surendra Kumar Mattoo. "Delusional disorders: An overview." German J Psychiatry 9 (2006): 62-73.
- ↑ Manschreck TC (1996). "Delusional disorder: the recognition and management of paranoia". J Clin Psychiatry. 57 Suppl 3: 32–8, discussion 49. PMID 8626368.
- ↑ de Portugal E, González N, Haro JM, Autonell J, Cervilla JA (2008). "A descriptive case-register study of delusional disorder". Eur Psychiatry. 23 (2): 125–33. doi:10.1016/j.eurpsy.2007.10.001. PMID 18082379.
- ↑ Ramos N, Wystrach C, Bolton M, Shaywitz J, IsHak WW (2013). "Delusional disorder, somatic type: olfactory reference syndrome in a patient with delusional trimethylaminuria". J Nerv Ment Dis. 201 (6): 537–8. doi:10.1097/NMD.0b013e31829482fd. PMID 23719328.