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Neuropsychopharmacology Reports Mar 2024Cenesthopathy is a rare syndrome characterized by strange bodily and oral sensations and is classified as a delusional disorder, somatic type, according to the fifth...
Cenesthopathy is a rare syndrome characterized by strange bodily and oral sensations and is classified as a delusional disorder, somatic type, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Cenesthopathy has been considered difficult to treat. However, to improve cenesthopathy, many pharmacotherapeutic options are reported, including antidepressants and antipsychotics. In this case report, vortioxetine significantly alleviated the distress of oral cenesthopathy in a patient with cerebral ischemia and depression without any adverse effects. To the best of our knowledge, this is the first report on the efficacy of vortioxetine in treating cenesthopathy. Though it is unclear why vortioxetine was effective for cenesthopathy in our case, we stated two possibilities for improving his oral cenesthopathy. When treating oral cenesthopathy in elderly patients, clinicians consider to be one of the options to prescribe vortioxetine.
Topics: Humans; Aged; Vortioxetine; Schizophrenia, Paranoid; Antidepressive Agents; Antipsychotic Agents
PubMed: 37794715
DOI: 10.1002/npr2.12384 -
Dermatology Online Journal Oct 2019The interplay between psychiatric and dermatologic conditions has been recognized for decades as evidenced by the widely accepted classification system of...
The interplay between psychiatric and dermatologic conditions has been recognized for decades as evidenced by the widely accepted classification system of psychocutaneous disorders: (1) primary dermatologic disorder with psychiatric sequelae, (2) primary dermatologic disorder exacerbated by stress, (3) primary psychiatric disorder with dermatologic sequelae, and (4) miscellaneous. However, there is minimal literature regarding dermatologic patients who demonstrate a preoccupation with a more severe cutaneous disorder despite evidence confirming a diagnosis of a minor, treatable skin condition. These patients are a hybrid of the first and fourth categories and should be classified under a new entity known as delusion inversus. These patients have a primary dermatologic condition; however, they believe their condition to be more severe and malignant than it is, despite evidence to the contrary. Their beliefs are pathological and analogous to delusion disorder somatic type. Given the scarcity of data concerning delusion inversus, the epidemiology, diagnosis, and management of the disorder as described in this review is extrapolated from reported cases of delusion disorder and delusion disorder somatic-type. Often these patients will present to a non-psychiatric, outpatient clinic for medical care. Thus, it is imperative that dermatologists are able to identify the condition and manage the patient appropriately.
Topics: Delusions; Diagnosis, Differential; Female; Humans; Hypochondriasis; Middle Aged; Prevalence; Psychophysiologic Disorders; Schizophrenia, Paranoid; Skin Diseases; Socioeconomic Factors
PubMed: 31735003
DOI: No ID Found -
Comprehensive Psychiatry Aug 2018The relationship between personality and Delusional Disorder in still debated. The present study aimed to evaluate the role of personality features and emotional...
The relationship between personality and Delusional Disorder in still debated. The present study aimed to evaluate the role of personality features and emotional dispositions on the proneness to delusional beliefs, through the lens of a dimensional approach. 91 outpatients were administered the Structured Interview for DSM-IV Personality Disorders, the Pathological Narcissism Inventory, the Positive and Negative Affect Schedule and the Peters et al. Delusions Inventory. Delusion proneness was positively related to the "Hiding the Self" domain of narcissistic vulnerability and to paranoid traits and negatively related to "Positive Affect". Paranoid traits and "Hiding the Self" significantly interacted in influencing delusion ideation. These data suggest that proneness to delusion depends, at least in part, on a complex interplay between specific emotional and paranoid dispositions within personality.
Topics: Adult; Aged; Delusions; Emotions; Female; Humans; Male; Middle Aged; Narcissism; Personality Disorders; Schizophrenia, Paranoid
PubMed: 30005180
DOI: 10.1016/j.comppsych.2018.07.002 -
Vertex (Buenos Aires, Argentina) 2012In 1987, the revision of the DSM-III reintroduced the concept of paranoia under the name of delusional disorder. Most of the actual evidence about the pharmacological...
In 1987, the revision of the DSM-III reintroduced the concept of paranoia under the name of delusional disorder. Most of the actual evidence about the pharmacological treatment of this disorder is derived from case series and case reports. Antipsychotics have been used for the treatment of delusional disorder since 1970s, with pimozide as a first line drug. The introduction of second generation antipsychotics changed the treatment of the disorder. In spite of the available information, delusional disorder remains to this day a controversial and complex disorder.
Topics: Humans; Schizophrenia, Paranoid
PubMed: 23170296
DOI: No ID Found -
The Journal of the American Academy of... Mar 2015Delusional disorder has important implications for forensic psychiatrists, as delusions are not infrequently related to criminal behavior. Thus, we hypothesized that...
Delusional disorder has important implications for forensic psychiatrists, as delusions are not infrequently related to criminal behavior. Thus, we hypothesized that delusional disorder is over-represented in correctional populations. We conducted a retrospective chart review of the electronic medical records from 2000 to 2012 of New Jersey Department of Corrections inmates who remained incarcerated as of March 2012. Potential cases of delusional disorder were initially identified by using a search for current or past diagnoses of such disorders or other diagnoses that could be misdiagnosed cases. After an initial chart review identified an inmate as having probable delusional disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria, the diagnosis was confirmed by at least one concurring independent review. We estimate a point prevalence of 0.24 percent for delusional disorder in our population, which is eight times higher than that expected in the community.
Topics: Adult; Criminal Psychology; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Electronic Health Records; Humans; Mass Screening; New Jersey; Pilot Projects; Prisoners; Prisons; Prognosis; Psychotic Disorders; Reference Values; Retrospective Studies; Schizophrenia, Paranoid; Treatment Outcome
PubMed: 25770283
DOI: No ID Found -
Schizophrenia Research Feb 2019Previous evidence suggests that delusional disorder has a later onset and better functional outcomes compared to schizophrenia. However, studies have not examined...
BACKGROUND
Previous evidence suggests that delusional disorder has a later onset and better functional outcomes compared to schizophrenia. However, studies have not examined longitudinal outcomes in a first episode population, where confounding factors may be adjusted for.
METHODS
A nested case control study was designed within the National EDEN study; a cohort of 1027 first episode psychosis patients. Patients with a baseline diagnosis of delusional disorder (n = 48) were compared with schizophrenia (n = 262) at 6 and 12 months with respect to symptomatic and functional outcomes. Regression analysis was used to adjust for possible confounders.
RESULTS
Delusional disorder patients had a shorter duration of untreated psychosis compared to schizophrenia but were similar in other baseline characteristics. At baseline, delusional disorder patients had lower symptom scores but higher function scores compared to those with schizophrenia. At 12 months the differences persisted for symptoms scores but not overall function scores. After adjusting for baseline score, age and duration of untreated psychosis, differences between the groups remained significant only for Positive and Negative Syndrome Scale (PANNS) negative, general and total scores and recovery rates. There were no differences in changes in outcomes scores.
CONCLUSIONS
Delusional disorder in a first episode psychosis population presents with less severe symptoms, higher recovery rates and better functioning than schizophrenia, but at 12 months differences are ameliorated when adjusting for baseline differences.
Topics: Adolescent; Adult; Case-Control Studies; Early Medical Intervention; Female; Humans; Longitudinal Studies; Male; Outcome Assessment, Health Care; Psychotic Disorders; Schizophrenia; Schizophrenia, Paranoid; Young Adult
PubMed: 30195583
DOI: 10.1016/j.schres.2018.08.036 -
Canadian Journal of Psychiatry. Revue... Jan 2018To contribute to a better differential clinical categorisation of delusional disorder (DD) versus schizophrenia (SZ) and to add and complete evidence from previous... (Comparative Study)
Comparative Study
OBJECTIVE
To contribute to a better differential clinical categorisation of delusional disorder (DD) versus schizophrenia (SZ) and to add and complete evidence from previous clinical studies of DD compared to schizophrenia.
METHODS
A cross-sectional study using a clinical sample of 275 patients (132 patients with DD) was studied. Patients were consecutively attending public clinics located in urban and rural areas in both Andalusia and Catalonia (Spain). All participants met DSM-IV diagnostic criteria for either DD or SZ. Data were gathered on sociodemographics, illness duration, Barona-Index estimation of intelligence quotient (IQ), and global functioning, along with a thorough psychopathological assessment using the Positive and Negative Syndrome Scale (PANSS). Comparisons between both groups were calculated using χ, Student t, and multivariate analysis of covariance tests.
RESULTS
Patients with DD were older (mean [SD], 50.3 [14.6] years vs. 36.6 [11.1] years; t = 8.597; P ≤ 0.0001), were more frequently married (45.4% vs. 10.8%; χ = 38.569; P ≤ 0.0001), and had a higher mean estimated premorbid IQ (111.4 vs. 105.4; t = 2.609; P ≤ 0.01). On the other hand, SZ patients were predominantly male (71.4% vs. 48.9%; χ = 14.433; P ≤ 0.0001) and had greater work-related disability than DD patients (20.5% vs. 50.3%; χ = 19.564; P ≤ 0.001). Overall, the DD group showed a less severe PANSS psychopathology than SZ group. Thus, total mean (SD) PANSS scores for schizophrenia and delusional disorder, respectively, were 76.2 (22.4) versus 54.1 (18.4) ( t = -8.762; P ≤ 0.0001). Moreover, patients with DD showed a better global functioning than those with SZ (62.7 [13.2] vs. 51.9 [16.9]; F = 44.114; P ≤ 0.0001).
CONCLUSIONS
DD is a milder and distinct disorder compared to SZ in terms of psychopathology and global functionality.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Schizophrenia; Schizophrenia, Paranoid; Spain; Young Adult
PubMed: 28595494
DOI: 10.1177/0706743717706347 -
Journal of Clinical Psychopharmacology Aug 2013Delusional disorder is an uncommon, yet not rare, psychotic disorder. Because of the distinct lack of high-evidence-level research conducted in this area, no definitive... (Comparative Study)
Comparative Study Review
UNLABELLED
Delusional disorder is an uncommon, yet not rare, psychotic disorder. Because of the distinct lack of high-evidence-level research conducted in this area, no definitive clinical guidelines are available on its treatment. The aim of this article was to summarize the current literature on the pharmacological treatment of delusional disorder in the form of a review, as well as to analyze a series of 6 cases treated at the Department of Psychiatry at "Charité-University Medicine Berlin, Campus Benjamin Franklin" between 2005 and 2011; in each case paying special attention to the relative efficacy and acceptability of the antipsychotics used.
REVIEW
A MEDLINE search was conducted to capture all articles on the treatment of delusional disorder published since 2004. After viewing titles and abstracts, these articles were then assessed for relevance.
CASE SERIES
The files of 6 cases of delusional disorder treated at the previously mentioned clinic were analyzed and information regarding the type of medication, dose, and duration of treatment as well as adverse effects was extracted and summarized. In line with previous studies, it was found that delusional disorder has a moderate prognosis when adequately treated and that noncompliance is often the reason for poor treatment results. Various novel antipsychotics as well as a combination of medication treatment and psychotherapy produced positive results. Generally, adverse effects were easily managed by a reduction in dose or a switch to another antipsychotic, and it was often necessary to try out a number of antipsychotics before arriving at a satisfactory solution.
Topics: Adult; Aged; Aged, 80 and over; Antipsychotic Agents; Drug Substitution; Female; Humans; Male; Patient Readmission; Retrospective Studies; Schizophrenia, Paranoid; Time Factors; Treatment Outcome
PubMed: 23771191
DOI: 10.1097/JCP.0b013e3182905796 -
International Psychogeriatrics Apr 2020
Topics: Australia; Delusions; Humans; Schizophrenia, Paranoid
PubMed: 32295673
DOI: 10.1017/S1041610219001352 -
Ryoikibetsu Shokogun Shirizu 2003
Review
Topics: Age of Onset; Diagnostic and Statistical Manual of Mental Disorders; Humans; Schizophrenia, Paranoid
PubMed: 12876939
DOI: No ID Found