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Revista de Psiquiatria Y Salud Mental 2017
Topics: Antidepressive Agents; Antipsychotic Agents; Cognitive Behavioral Therapy; Combined Modality Therapy; Comprehensive Health Care; Diagnosis, Differential; Humans; Schizophrenia, Paranoid
PubMed: 28476504
DOI: 10.1016/j.rpsm.2017.03.003 -
Neuropsychopharmacology : Official... Jun 2002Since delusional disorder is characterized by mono-symptomatic paranoid symptoms, it can be a good clinical model for investigating the dopaminergic mechanism... (Comparative Study)
Comparative Study
UNLABELLED
Since delusional disorder is characterized by mono-symptomatic paranoid symptoms, it can be a good clinical model for investigating the dopaminergic mechanism responsible for paranoid symptoms. We examined neuroleptic responses, plasma homovanillic acid (pHVA) and genes of the dopamine receptor (DR) and its synthesizing enzyme (tyrosine hydroxylase: TH) in patients with delusional disorder and compared them with those of schizophrenic patients and healthy controls.
RESULTS
(1) A relatively small dose of haloperidol was more effective for delusional disorder than for schizophrenia. (2) The pretreatment level of pHVA was higher in patients with persecution-type, but not in those with jealousy-type delusional disorder, compared with age- and sex-matched controls. This increased pHVA level was decreased eight weeks after successful haloperidol treatment. (3) The genotype frequency of the DRD2 gene Ser311Cys was significantly higher in patients with persecution-type delusional disorder (21%), compared with schizophrenic patients (6%) or controls (6%). (4) Patients homozygous for the DRD3 gene Ser9Ser had higher pretreatment levels of pHVA than those heterozygous for Ser9Gly. (v) A significant positive correlation was found between the polymorphic (TCAT)(n) repeat in the first intron of the TH gene and pretreatment levels of pHVA in delusional disorder. We suggest that delusional disorder, especially the persecution-type, includes a "dopamine psychosis," and that polymorphism of the DRD2, DRD3 and/or TH gene is part of the genetic basis underlying the hyperdopaminergic state that produces paranoid symptoms. Further studies on a large sample size are required.
Topics: Adult; Antipsychotic Agents; Female; Genotype; Homovanillic Acid; Humans; Male; Middle Aged; Psychotic Disorders; Receptors, Dopamine; Schizophrenia, Paranoid
PubMed: 12007750
DOI: 10.1016/S0893-133X(01)00421-3 -
The Journal of Neuropsychiatry and... 2021
Topics: Antipsychotic Agents; Female; Humans; Middle Aged; Neuropsychological Tests; Psychotic Disorders; Risperidone; Schizophrenia, Paranoid; Stroke; Time Factors
PubMed: 34213979
DOI: 10.1176/appi.neuropsych.20100260 -
Duodecim; Laaketieteellinen... 2011The number of persons over 65 years of age with schizophrenia will increase in the future. Geriatric schizophrenia involves bizarre delusions and hallucinations similar... (Review)
Review
The number of persons over 65 years of age with schizophrenia will increase in the future. Geriatric schizophrenia involves bizarre delusions and hallucinations similar to those occurring in younger schizophrenic patients. Delusions of an elderly delusional disorder patient focusing on the family and environment easily lead to social withdrawal. Persons becoming ill with initial psychosis at an older age should be subjected to thorough diagnostic examinations. Organic brain diseases constitute the major differential diagnostic illnesses. Second generation antipsychotics are the first-line drugs in the treatment of geriatric schizophrenia and delusional disorder. The patients benefit from a regular therapeutic contact and treatment of associated diseases.
Topics: Age Factors; Aged; Aged, 80 and over; Antipsychotic Agents; Diagnosis, Differential; Humans; Schizophrenia; Schizophrenia, Paranoid
PubMed: 21442857
DOI: No ID Found -
Comprehensive Psychiatry 2010This study assessed demographic and clinical features in 65 subjects with body dysmorphic disorder (BDD) and compared the 39 (60%) with the delusional form (receiving an... (Comparative Study)
Comparative Study
This study assessed demographic and clinical features in 65 subjects with body dysmorphic disorder (BDD) and compared the 39 (60%) with the delusional form (receiving an additional diagnosis of delusional disorder, somatic type) with those who did not meet delusionality criteria. Delusional and nondelusional patients did not statistically differ on most demographic and clinical variables. Delusional patients, however, had significantly more severe BDD symptoms at both baseline and follow-up assessments than those of nondelusional patients. Furthermore, poorer insight was significantly associated with more severe BDD symptoms at both baseline and follow-up. Overall improvement in BDD symptom severity was similar for the 2 groups. Our results support other studies in the view that BDD and its delusional variant have more similarities than differences and that the delusional variant may be simply a more severe form of BDD. Implications for the diagnostic classification of BDD and future research directions are discussed.
Topics: Adult; Body Dysmorphic Disorders; Delusions; Demography; Female; Humans; Male; Schizophrenia, Paranoid; Severity of Illness Index; Young Adult
PubMed: 20152299
DOI: 10.1016/j.comppsych.2009.05.001 -
Psychiatry and Clinical Neurosciences Oct 2007The aim of the present study was to study sociodemographic profile, clinical parameters including comorbidity, usefulness of antipsychotics especially atypicals, family...
The aim of the present study was to study sociodemographic profile, clinical parameters including comorbidity, usefulness of antipsychotics especially atypicals, family history, and follow-up rates for delusional disorder. The records of all subjects who were seen in the Department of Psychiatry during a period of 10 years (i.e. 1994-2003) were reviewed. Eighty-eight subjects fulfilling the inclusion criteria were enrolled. The sample consisted predominantly of female subjects (55.7%), most of the total subjects were married and had favorable social functioning. The most common delusion was persecutory (54.5%), followed by delusion of reference (46.6%). The majority of the subjects had a comorbid psychiatric disorder. Education was negatively correlated with age at onset and positively correlated with the number of delusions. Age at onset was negatively correlated with total number of delusions. The sociodemographic profile of delusional disorder is consistent across various cultures, has high comorbidity and, when treated appropriately, responds to various antipsychotic agents.
Topics: Adult; Aged; Aged, 80 and over; Alcoholism; Antipsychotic Agents; Bipolar Disorder; Comorbidity; Cross-Sectional Studies; Depressive Disorder, Major; Female; Genetic Predisposition to Disease; Humans; Incidence; India; Male; Middle Aged; Patient Compliance; Retrospective Studies; Schizophrenia, Paranoid; Treatment Outcome
PubMed: 17875023
DOI: 10.1111/j.1440-1819.2007.01694.x -
Medical Archives (Sarajevo, Bosnia and... Aug 2019Delusional disorder shares some clinical characteristics of OCD and hypochondriasis. Delusions compared to obsessions in the OCD and compared to bodily preoccupations in...
INTRODUCTION
Delusional disorder shares some clinical characteristics of OCD and hypochondriasis. Delusions compared to obsessions in the OCD and compared to bodily preoccupations in the hypochondriasis are more established beliefs.
AIM
To measure pituitary volumes in patients with delusional disorder and hypothesized that volumes would be reduced in those patients by a mechanism that we could not account for before for patients with OCD and hypochondriasis.
METHODS
Eighteen patients with delusional disorder and healthy controls were included into the study. Pituitary gland volumes were measured.
RESULTS
When using independent test, the mean total pituitary volume was 777.22±241.28 mm in healthy controls, while it was 532.11±125.65 mm in patients with delusional disorder. The differences in regard to pituitary gland volumes between patients with delusional disorder and healthy control subjects were statistically meaningful (<0.01), as supported by ANCOVA, with the covariates of age, gender and total brain volumes as covariates.
CONCLUSION
We determined that patients with delusional disorder had smaller pituitary volumes compared to those of healthy control subjects.
Topics: Adult; Case-Control Studies; Female; Humans; Magnetic Resonance Imaging; Male; Organ Size; Pituitary Gland; Schizophrenia, Paranoid
PubMed: 31762560
DOI: 10.5455/medarh.2019.73.253-256 -
Schizophrenia Research Dec 2015Since the early description of paranoia, the nosology of delusional disorder has always been controversial. The old idea of unitary psychosis has now gained some renewed...
INTRODUCTION
Since the early description of paranoia, the nosology of delusional disorder has always been controversial. The old idea of unitary psychosis has now gained some renewed value from the dimensional continuum model of psychotic symptoms.
AIMS
1. To study the psychopathological dimensions of the psychosis spectrum; 2. to explore the association between psychotic dimensions and categorical diagnoses; 3. to compare the different psychotic disorders from a psychopathological and functional point of view.
MATERIAL AND METHODS
This is an observational study utilizing a sample of some 550 patients with a psychotic disorder. 373 participants had a diagnosis of schizophrenia, 137 had delusional disorder and 40 with a diagnosis of schizoaffective disorder. The PANSS was used to elicit psychopathology and global functioning was ascertained using the GAF measure. Both exploratory and confirmatory factor analyses of the PANSS items were performed to extract psychopathological dimensions. Associations between diagnostic categories and dimensions were subsequently studied using ANOVA tests.
RESULTS
5 dimensions - manic, negative symptoms, depression, positive symptoms and cognitive - emerged. The model explained 57.27% of the total variance. The dimensional model was useful to explained differences and similarities between all three psychosis spectrum categories. The potential clinical usefulness of this dimensional model within and between clinical psychosis spectrum categories is discussed.
Topics: Adult; Analysis of Variance; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Principal Component Analysis; Psychiatric Status Rating Scales; Psychopathology; Psychotic Disorders; Schizophrenia; Schizophrenia, Paranoid; Schizophrenic Psychology; Young Adult
PubMed: 26585220
DOI: 10.1016/j.schres.2015.10.039 -
Psychopathology 2019Delusional disorder (DD) is still considered a diagnosis of exclusion for a difficult-to-treat condition characterised by the presence of delusional beliefs in the...
Delusional disorder (DD) is still considered a diagnosis of exclusion for a difficult-to-treat condition characterised by the presence of delusional beliefs in the absence of other psychiatric symptoms. Attempts to contextualise psychological processes recognised since the earliest observations of this disorder have had very limited impact on improving some fixed beliefs. In the Cambridge Early Intervention in Psychosis Service we have observed a particular phenomenon, often categorised as a delusional idea in the context of DD, which manifests through highly repetitive belief expression that fails to respond to pharmacological and psychological treatments. Key aspects of this phenomenon are similar to those observed in dissociative (functional neurological) presentations. Drawing on the Integrative Cognitive Model of functional neurological disorders, we developed a successful psychological intervention that places less emphasis on challenging delusional content and focuses more on dismantling dissociation and underlying affective factors associated with the activation of the fixed belief. Our initial findings reinforce the need to continue developing a multi-level phenomenological approach to define a variety of symptoms traditionally grouped under the concept of "delusion."
Topics: Delusions; Dissociative Disorders; Female; Humans; Middle Aged; Schizophrenia, Paranoid
PubMed: 31085924
DOI: 10.1159/000499596 -
Time for Rational Pharmacotherapy in Delusional Disorder: New Targets for Old Clinical Observations.Journal of Clinical Psychopharmacology
Topics: Delusions; Humans; Schizophrenia, Paranoid
PubMed: 35652732
DOI: 10.1097/JCP.0000000000001570