Delusional disorder natural history, complications and prognosis
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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
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. Common complications of [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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 .