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Progress in Neuro-psychopharmacology &... Feb 19981. The effects of pimozide on the psychopathology of delusional disorder were studied. 2. After six weeks, pimozide (2-12 mg/day) administration had no effect on the...
1. The effects of pimozide on the psychopathology of delusional disorder were studied. 2. After six weeks, pimozide (2-12 mg/day) administration had no effect on the Brief Psychiatric Rating Scale, or in the psychological, social and occupational functioning, as measured by the Global Assessment of Functioning Scale. 3. When the different dimensions of the delusional experience were looked upon, no modifications were observed in any of them after six weeks of pimozide treatment. 4. These data failed to support the therapeutic role of pimozide in the treatment of delusional disorder and may suggest, when compared to other disorders with prominent delusions such as schizophrenia, a different neurobiology for the illness.
Topics: Adult; Antipsychotic Agents; Female; Humans; Male; Middle Aged; Pimozide; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Treatment Outcome
PubMed: 9608605
DOI: 10.1016/s0278-5846(98)00008-6 -
Canadian Journal of Psychiatry. Revue... May 2006Genetic associations between delusional disorder and paranoid schizophrenia are not well understood, although involvement of biological factors has been suspected. We...
OBJECTIVES
Genetic associations between delusional disorder and paranoid schizophrenia are not well understood, although involvement of biological factors has been suspected. We investigated the incidence of human leukocyte antigen (HLA) class I alleles in patients with delusional disorder and paranoid schizophrenia, first, to explore a possible immunogenetic etiology of these paranoid disorders and, second, to determine whether they share similar etiologic mechanisms.
METHOD
We employed a nested case-control study design. Psychiatric reference data were available for 38,500 patients attending a hospital-based psychiatric outpatient department between 1998 and 2005. We enrolled 100 patients with delusional disorder and 50 patients with paranoid schizophrenia as the subject cases, using DSM-IV criteria. We considered equivalent numbers of healthy volunteers matched for age and ethnic background as control subjects. All subjects came from an India-born Bengali population. We applied the polymerase chain reaction-based molecular typing method to all patients and healthy subjects.
RESULTS
The HLA-A*03 gene is significantly associated with delusional disorder as well as with paranoid schizophrenia. This HLA gene alone or in linkage disequilibrium with other HLA genes or other closely linked non-HLA genes may influence susceptibility to delusional disorder and paranoid schizophrenia.
CONCLUSIONS
The study reveals important associations between HLA genes and paranoid disorders. Delusional disorder and paranoid schizophrenia may share similar etiologic mechanisms. This preliminary observation may help our understanding of the genetic basis of these paranoid disorders.
Topics: Adult; Alleles; Case-Control Studies; Female; Gene Frequency; Genetic Predisposition to Disease; HLA-A Antigens; HLA-A3 Antigen; Histocompatibility Antigens Class I; Humans; Immunogenetics; India; Linkage Disequilibrium; Male; Middle Aged; Reference Values; Schizophrenia, Paranoid; Statistics as Topic
PubMed: 16786814
DOI: 10.1177/070674370605100602 -
Comprehensive Psychiatry Apr 2013Since Kraepelin, the controversy has persisted surrounding the nature of delusional disorder (DD) as a separate nosological entity or its clinical subtypes....
AIMS
Since Kraepelin, the controversy has persisted surrounding the nature of delusional disorder (DD) as a separate nosological entity or its clinical subtypes. Nevertheless, there has been no systematic study of its psychopathological structure based on patient interviews. Our goal was to empirically explore syndromic subentities in DD.
METHODS
A cross-sectional study was conducted in 86 outpatients with DSM-IV-confirmed DD using SCID-I. Psychopathological factors were identified by factor analysis of PANSS scores. The association between these factors and clinical variables (as per standardized instruments) was analyzed using uni- and multivariate techniques.
RESULTS
PANSS symptoms were consistent with four factors (Paranoid, Cognitive, Schizoid, and Affective dimensions), accounting for 59.4% of the total variance. The Paranoid Dimension was associated with premorbid paranoid personality disorder, more adverse childhood experiences, chronic course, legal problems, worse global functioning, and poorer treatment adherence and response. The Cognitive Dimension was associated with poorer cognitive functioning, premorbid substance abuse, comorbid somatic diseases, mainly non-prominent visual hallucinations, fewer comorbid depressive disorders, and poorer global functioning. The Schizoid Dimension was associated with being single, a family history of schizophrenia, premorbid personality disorders (largely schizoid and schizotypal), non-prominent auditory hallucinations, and dysthymia. Finally, the Affective Dimension was associated with a family history of depression, premorbid obsessive personality, somatic delusions, absence of reference delusions, tactile and olfactory hallucinations, depressive and anxiety disorders, risk of suicide, and higher perceived stress.
CONCLUSION
The identification and clinical validation of four separate psychopathological dimensions in DD provide evidence toward a more accurate conceptualization of DD and its types.
Topics: Adult; Aged; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Factor Analysis, Statistical; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 23021895
DOI: 10.1016/j.comppsych.2012.08.002 -
International Clinical... Sep 2018This review aimed to examine and analyse the definitions used for antipsychotic response in delusional disorder (DD) and to provide a discussion of the methodology used....
This review aimed to examine and analyse the definitions used for antipsychotic response in delusional disorder (DD) and to provide a discussion of the methodology used. A systematic review was performed using the PubMed, Scopus and PsycINFO databases (1990-October 2017) according to the PRISMA statement. In addition, reference searches were performed manually through identified studies to obtain other relevant articles. The search terms included 'antipsychotic response', 'antipsychotics', 'treatment response' and 'delusional disorder'. After the screening and selection processes, 11 studies fulfilled our inclusion criteria using different methods to define antipsychotic response in DD. Studies included chart reviews (n=5) and observer-rated scales (n=6), in which two studies used the Clinical Global Impression-Improvement scale, two studies evaluated antipsychotic response by mean changes from the baseline to endpoint scores [Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale], one study combined the Clinical Global Impression-Improvement scale and mean changes from baseline scores (PANSS) and one study reported responder rates on the basis of a scale-derived cut-off (PANSS). A lack of consensus in the definitions of antipsychotic response in DD and a high degree of heterogeneity of the methods used are reflected. Recent proposals on the use of scale-derived cut-offs to evaluate antipsychotic response in schizophrenia would be highly recommended for DD research.
Topics: Antipsychotic Agents; Humans; Psychiatric Status Rating Scales; Randomized Controlled Trials as Topic; Schizophrenia, Paranoid
PubMed: 29912058
DOI: 10.1097/YIC.0000000000000227 -
Cognitive Neuropsychiatry Sep 2006Introduction. Delusional disorders are characterised by monothematic, "encapsulated" and incorrigible false beliefs and misinterpretations of social signals. Due to the...
Introduction. Delusional disorders are characterised by monothematic, "encapsulated" and incorrigible false beliefs and misinterpretations of social signals. Due to the rarity of cases with "pure" delusional disorder (DD) in clinical settings most studies of social cognition in delusional patients have focused on patients with paranoid schizophrenia. In the present study we sought to examine emotion recognition, theory of mind abilities, and pragmatic language comprehension in patients with delusional disorder. Methods. Social cognition was assessed in 21 patients recruited over a 3-year period who were diagnosed with delusional disorder, paranoid, erotomanic, or jealous type. In addition to an emotion recognition and theory of mind test battery, we included a novel German Proverb Test, which has been found indicative of subtle theory of mind deficits in schizophrenic patients. Executive functioning was assessed using the Wisconsin Card Sorting Test (WCST). Psychopathology was measured using the Positive and Negative Symptoms Scale (PANSS). Patients' task performance was compared to a group of 22 healthy control persons paralleled for verbal intelligence, education, and age. Results. Patients with DD made significantly more perseverative errors in the WCST, they performed more poorly on the theory of mind tasks and the proverb test, but were unimpaired in basic emotion recognition abilities relative to controls. When executive functioning was co-varied out, the group differences in theory of mind disappeared, whereas the greater propensity of patients with DD to interpret proverbs literally remained significant. Conclusions. In "pure" DD the basic social cognitive abilities appear to be preserved. Difficulties in metaphorical speech comprehension and executive functioning could, however, indicate more subtle social cognitive deficits in these patients.
Topics: Adult; Aged; Bipolar Disorder; Cognition; Education; Female; Humans; Intelligence Tests; Jealousy; Language Tests; Male; Middle Aged; Paranoid Disorders; Psychiatric Status Rating Scales; Psychomotor Performance; Schizophrenia, Paranoid; Sexual Behavior; Social Perception
PubMed: 17354084
DOI: 10.1080/13546800500359994 -
Psychiatry Research Dec 2013The aim of this study was to investigate the presence of premorbid Personality Disorder (PD) and its relationship with clinical correlates in patients with Delusional...
The aim of this study was to investigate the presence of premorbid Personality Disorder (PD) and its relationship with clinical correlates in patients with Delusional Disorder (DD). Eighty-six outpatients with DD whose diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Axis I (SCID-I) Disorders (psychosis module) were evaluated for premorbid PD utilizing the Standardized Assessment of Personality (SAP). Psychopathology was assessed using Module B of SCID-I and the Positive and Negative Syndrome Scale (PANSS); psychosocial functioning was evaluated with the Global Assessment of Functioning scale. Premorbid intelligence was assessed using the Wechsler Adult Intelligence Scale-Third Edition, vocabulary subtest. A sociodemographic-clinical questionnaire was completed. Sixty-four percent of the patients had at least one premorbid PD, the most common being paranoid PD (38.4%), followed by schizoid PD (12.8%). The presence of at least one premorbid PD was significantly associated with higher scores for psychopathology, in particular, on the affective dimension of DD symptoms. However, the presence of premorbid PD was not associated with psychosocial functioning. Each of the premorbid PD was associated with different psychopathological profiles. Premorbid PD is a relevant phenomenon in DD, given its high prevalence and comorbidity, its influence on clinical correlates and its potential ability to predict specific sub-syndromes.
Topics: Adolescent; Adult; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Outpatients; Personality Disorders; Personality Inventory; Prevalence; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia, Paranoid; Surveys and Questionnaires
PubMed: 23993136
DOI: 10.1016/j.psychres.2013.07.028 -
Journal of Clinical Psychopharmacology Dec 2005
Topics: Aged; Antidepressive Agents; Antipsychotic Agents; Dibenzothiazepines; Drug Therapy, Combination; Female; Humans; Quetiapine Fumarate; Schizophrenia, Paranoid; Sertraline; Stroke
PubMed: 16282853
DOI: 10.1097/01.jcp.0000185344.39849.63 -
Canadian Journal of Psychiatry. Revue... Aug 2001
Topics: Aged; Alzheimer Disease; Atrophy; Brain; Dementia, Vascular; Dominance, Cerebral; Female; Humans; Male; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Tomography, X-Ray Computed
PubMed: 11526819
DOI: 10.1177/070674370104600619 -
Ryoikibetsu Shokogun Shirizu 2003
Review
Topics: Antipsychotic Agents; Brain Diseases; Endocrine System Diseases; Humans; International Classification of Diseases; Schizophrenia, Paranoid
PubMed: 14626093
DOI: No ID Found -
BMC Psychiatry Nov 2022Paliperidone is a second-generation antipsychotic agent that is effective in the treatment of schizophrenia and schizoaffective disorder as well as an adjunct to mood...
Long-acting injectable paliperidone palmitate induced severe cutaneous allergic reaction in a patient with first episode delusional disorder tolerating oral paliperidone regimen: a case report.
BACKGROUND
Paliperidone is a second-generation antipsychotic agent that is effective in the treatment of schizophrenia and schizoaffective disorder as well as an adjunct to mood stabilizers and antidepressants for bipolar and depressive disorders. Paliperidone is available in both oral and injection forms. Here we report an unexpected case of cutaneous allergic reaction induced by paliperidone long-acting injection (LAI) following oral tolerance.
CASE PRESENTATION
A 55-year-old man with first episode delusional disorder was treated with paliperidone tablets with tolerance. On day seven he received the paliperidone LAI and developed an allergic reaction in minutes including flushing of the face, widespread urticaria with mild airway constriction. The allergic symptoms were relived following the administration of antihistamine within several minutes.
CONCLUSION
The allergic reaction that occurred post administration of the paliperidone LAI but not the oral tablets suggest it is likely due to the excipients in the formulation of the LAI rather than paliperidone itself. This case highlights the necessity of monitoring allergic reactions in psychiatric patients when converting from oral to LAI format of paliperidone.
Topics: Male; Humans; Middle Aged; Paliperidone Palmitate; Schizophrenia, Paranoid; Delayed-Action Preparations; Antipsychotic Agents; Hypersensitivity
PubMed: 36434603
DOI: 10.1186/s12888-022-04347-7