Delusional disorder natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
==Natural History==
==Natural History==
The onset of delusional disorder can be acute, even sudden, or less commonly the disorder develops gradually. An acute onset has been associated with the presence of a precipitating event [30]. Delusions are often the initial manifestation of the disorder, but premorbid traits, including odd behavior and personality changes, have been reported in some cases [31].Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms). Delusional disorder is often a disabling illness. The condition often disrupts progress toward personal and occupational goals; patients with the disorder typically achieve less in their lives than their innate abilities would suggest. In our clinical experience, the course can be influenced by personal circumstances (eg, education, socioeconomic status, and physical health), the availability of personal support, and willingness to maintain treatment. Delusional disorder can be a source of profound individual and familial suffering. In cases of delusional jealousy and erotomania, the suffering can extend to other victims as well. Available data suggest that patients with delusional disorders have a better global outcome than patients with schizophrenia [10]. Unfortunately, patients with delusional disorder do not have good insight into their pathological experiences. Interestingly, despite significant delusions, many other psychosocial abilities remain intact, as if the delusions are circumscribed. Indeed, this is one of the key differences between delusional disorder and other primary psychotic disorders. However, the individual may rarely seek psychiatric help, remain isolated, and often present to internists, surgeons, dermatologists, policemen, and lawyers rather than psychiatrists. Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.
The onset of delusional disorder can be acute, sudden, or less commonly the disorder develops gradually. If the onset is acute, it is usually associated with the presence of a precipitating event. Delusions are often the initial manifestation of the delusional disorder, but some premorbid traits which include odd behavior and personality changes, have been reported in some cases. Delusional disorder is commonly a chronic condition, but if properly treated, the majority of people with this disorder can find relief from their symptoms. Some people recover completely from delusional disorders and others experience episodes of delusional beliefs with periods of remission. Delusional disorder is generally a disabling illness. The condition often disrupts progress to occupational and personal goals; patients with the delusional disorder typically achieve less in their lives than their innate abilities would propound. However, the clinical course can be influenced by the availability of personal support, personal circumstances such as education, socioeconomic status, and physical health, and willingness to maintain treatment. The other psychosocial abilities usually remain intact in patients with delusional disorders. The majority of the individuals with delusional disorders may rarely seek psychiatric help, remain isolated, and often present to surgeons, internists, policemen, and lawyers rather than psychiatrists. The majority of people with the delusional disorders do not seek help. Without treatment, delusional disorder can be a life-long illness.
==Complications==
==Complications==
Complications of delusional disorder include the following:
Complications of delusional disorder include the following:
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*People with the delusional disorder can eventually become isolated from others, especially if their delusions interfere with their relationships.
*People with the delusional disorder can eventually become isolated from others, especially if their delusions interfere with their relationships.
==Prognosis==
==Prognosis==
The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person's life circumstances, including the availability of support and a willingness to stick with treatment. Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms). Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.A commonly held view is that the course of the disorder is relatively persistent and stable; in fact, limited study suggests a more varied course. A study of 301 cases reported remission in about one-third of cases [30]. In approximately two-thirds of cases, the course of the disorder is life-long, with delusions present continuously in some cases and periodically in others [30,32]. The diagnostic stability of delusional disorder is less than that of some psychotic disorders; the most frequent change in diagnosis is to schizophrenia [33].
The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person's life circumstances, including the availability of support and a willingness to stick with treatment. Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms). Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.A commonly held view is that the course of the disorder is relatively persistent and stable; in fact, limited study suggests a more varied course. A study of 301 cases reported remission in about one-third of cases [30]. In approximately two-thirds of cases, the course of the disorder is life-long, with delusions present continuously in some cases and periodically in others [30,32]. The diagnostic stability of delusional disorder is less than that of some psychotic disorders; the most frequent change in diagnosis is to schizophrenia [33].Available data suggest that patients with delusional disorders have a better global outcome than patients with schizophrenia .  


==References==
==References==
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{{reflist|2}}

Revision as of 05:26, 3 December 2015

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

Overview

Natural History

The onset of delusional disorder can be acute, sudden, or less commonly the disorder develops gradually. If the onset is acute, it is usually associated with the presence of a precipitating event. Delusions are often the initial manifestation of the delusional disorder, but some premorbid traits which include odd behavior and personality changes, have been reported in some cases. Delusional disorder is commonly a chronic condition, but if properly treated, the majority of people with this disorder can find relief from their symptoms. Some people recover completely from delusional disorders and others experience episodes of delusional beliefs with periods of remission. Delusional disorder is generally a disabling illness. The condition often disrupts progress to occupational and personal goals; patients with the delusional disorder typically achieve less in their lives than their innate abilities would propound. However, the clinical course can be influenced by the availability of personal support, personal circumstances such as education, socioeconomic status, and physical health, and willingness to maintain treatment. The other psychosocial abilities usually remain intact in patients with delusional disorders. The majority of the individuals with delusional disorders may rarely seek psychiatric help, remain isolated, and often present to surgeons, internists, policemen, and lawyers rather than psychiatrists. The majority of people with the delusional disorders do not seek help. Without treatment, delusional disorder can be a life-long illness.

Complications

Complications of delusional disorder include the following:

  • Depression
  • Acting on the delusions also can lead to violence or legal problems
  • People with the delusional disorder can eventually become isolated from others, especially if their delusions interfere with their relationships.

Prognosis

The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person's life circumstances, including the availability of support and a willingness to stick with treatment. Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms). Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.A commonly held view is that the course of the disorder is relatively persistent and stable; in fact, limited study suggests a more varied course. A study of 301 cases reported remission in about one-third of cases [30]. In approximately two-thirds of cases, the course of the disorder is life-long, with delusions present continuously in some cases and periodically in others [30,32]. The diagnostic stability of delusional disorder is less than that of some psychotic disorders; the most frequent change in diagnosis is to schizophrenia [33].Available data suggest that patients with delusional disorders have a better global outcome than patients with schizophrenia .

References