Delusional disorder classification

Delusional disorder Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Delusions from other Diseases
Epidemiology and Demographics
Comorbid Conditions
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Delusional disorder classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Delusional disorder classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Delusional disorder classification
CDC on Delusional disorder classification
Delusional disorder classification in the news
Blogs on Delusional disorder classification
Directions to Hospitals Treating Tongue cancer
Risk calculators and risk factors for Delusional disorder classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Delusional disorder may be classified according to Diagnostic and Statistical Manual based on content of the delusions into seven subtypes: erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified.

Classification

Diagnosis of a specific type of delusional disorder can sometimes be made based on the content of the delusions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) enumerates seven types:

Subtypes of delusional disorder	Description
Erotomanic	The patient believes that another person is secretly in love with her or him. The person which patient believes is in love may be famous or have some kind of higher status, usually not part of the patient’s social circle, and not likely to be attainable. Affected individuals may attempt to communicate with the object of their affection and may attempt to meet him/her in person. Such effort can lead to stalking in some cases, with some risk for assaultive behavior. Expressions of love may be intense, and rejections by the loved person is interpreted oddly as affirmations of love to deflect suspicions or jealousy from the loved person’s spouse. Other names of erotomanic delusional disorder: DeClerambault syndrome, erotomania, psychose passionelle.
Grandiose	The patient believes he/she has special prominence or talent, major achievements, or unusual fame. Features of the patient’s thinking may suggest the grandiosity associated with mania, however in the delusional disorder, the mood disturbance and behaviors characteristic of mania are not present.
Jealous	The delusional theme is the patient believes that a spouse or lover is unfaithful and finds "evidence" to support the delusion, accuses him or her, and relentlessly tries to substantiate the offense. The delusion of jealousy can lead to aggressive, possibly violent, and threatening behavior, including homicide and suicide. In some cases delusional jealousy and its disruptive impact may only improve through separation from the suspected unfaithful partner. Other names of jealous delusional disorder: pathological or morbid jealousy, Othello syndrome, conjugal paranoia.
Persecutory	The patient is typically preoccupied by a delusion that he or she is being persecuted, potentially harmed, or conspired against. His/her resulting actions are generally consistent with these concerns; they are well planned and executed, and carried out with emotional vigor and determined effort. The individuals with persecutory delusions may resort to the courts and even to violence to right the wrongs directed at them.
Somatic	The patient believes that something awful is wrong with his/her body. There are several forms: that one is ill with undiagnosed disease; that one is infested with parasites or insects (delusional parasitosis); or that parts of the body are ugly, misshapen, or emanate a foul odor. Individuals generally go from one doctor to another, specialist to specialist, usually disappointed by the failure to detect and diagnose the medical problem that haunts them. Suicide may be a risk, thought due to frustration and lack of effective clinical intervention. Other names of somatic delusional disorder: hypochondriacal delusion, monosymptomatic hypochondriasis.
Mixed	More than one delusional theme predominates.
Unspecified	The dominant delusional belief cannot be clearly determined or is not described by the subtypes above.

• Other notable differences between the DSM-IV and DSM-5 diagnostic criteria are a clearer demarcation of delusional disorder in DSM-5 from psychotic variants of obsessive compulsive disorder and body dysmorphic disorder that is made explicit with a new exclusion criterion. Such a presentation must not be better explained by obsessive compulsive or body dysmorphic disorder with lack of insight/delusional beliefs.

• Shared delusional disorder is no longer separated from delusional disorder as in DSM-IV. If the criteria for delusional disorder are met, delusional disorder is the appropriate diagnosis. If that diagnosis cannot be made yet shared delusional beliefs are present, the appropriate diagnosis is "other specified schizophrenia spectrum and other psychotic disorder."
• Among them persecutory and jealous subtypes are the most common, and erotomanic and grandiose are the least common.

References

Template:WikiDoc Sources