Delusional disorder

Delusional disorder is a mental illness typified by the occurrence of non-bizarre delusions which are present for at least one month. Non-bizarre delusions are beliefs that may be plausible in a real life scenario such as belief that a significant someone is cheating or that an activity is under observation of an intelligence bureau. ^[1]

Epidemiology

Prevalence is estimated to be 0.03% in the U.S. Average age of patients is 40 years old. Age range based from studies is 18-90. Females are more commonly affected but males are more frequently reported in paranoid delusion cases. ^[2]

Causes

The exact cause is unknown. Several factors are considered in the causation of the delusional disorder including genetics and psychological factors. Some imply also biochemical factors in the pathophysiology of the disease For instance, studies found out that some patients who have neurologic disorders and medical conditions that involve certain brain areas like basal ganglia and temporal lobe develop the condition.

Factors that may increase the risk of having the disorder include being married, recent immigration, poverty, celibacy among males, and widowhood among females. ^[2]

Symptoms

The principal manifestation is a constant delusion or fixed belief which is essentially not occurring but is possible in real life setting. There are several types of delusional disorder. In the erotomanic type, the patient believes being involved in a romantic relationship with someone more often than not a famous individual. In the grandiose type, the patient supposes that he or she has a special power or capability such as being in a high political seat or have made some noteworthy discovery. In the jealous type, as the name implies, the patient has a belief that his or her significant other is being adulterous. Patients with the persecutory type think that they are being threatened while those with somatic type firmly believe that they have a physical illness. Mixed type is a combination of two or more types previously stated. ^[3]

Diagnosis

Medical history and physical exam are important. Interviews conducted on other people such as an immediate family member may verify whether the patient’s beliefs are factual or not. Diagnostic tests that may be done to exclude other medical illnesses are electroencephalogram (EEG), magnetic resonance imaging (MRI) or computed tomography (CT) scans. ^{[3] [4]}        

Treatment

Patient’s denial is often a challenge to treatment. When medication is started, antischyotic drugs like risperidone and quetiapine are often prescribed. Psychotherapy is frequently helpful particularly cognitive therapy for individuals with persecutory type. Social support and reassurance are extremely important.  ^[2]

References:

1.      http://psychcentral.com/disorders/delusional-disorder-symptoms/

2.      http://emedicine.medscape.com/article/292991-overview#aw2aab6b5

3.      http://www.intelihealth.com/IH/ihtPrint/WSIHW000/24479/31787.html?hide=t

4.      http://www.minddisorders.com/Br-Del/Delusional-disorder.html