Delusional Disorder

Persistent delusional disorder Age group 35-55 Single or divorced Duration 3 months or more Predisposing factors: • • • • • •

paranoid premorbid traits Stubborn immigrants deafness blindness educational disadvantage

• Non-bizarre systematised delusions • Foothold in reality, keeping with cultural norms Auditory & visual hallucinations not prominent while olfactory & tactile hallucinations may be prominent • Personality remains intact • Full recovery in 30%, severe impairment in 20%

Delusional disorder Sub-types Persecutory • Victim of a plot • Everyday actions viewed as offensive

Erotomania • •

Hypochondriacal disorder • delusional belief about bodily ill health • Olfactory, dysmorphic, infestation type

Delusional jealousy • Delusion of wife's infidelity • Search for proof & confession

Someone of higher status lover her Everyday encounters related to affair

Dysmorphophobia • •

Presumed defect in appearance Mirror checking & assurance seeking

Psychoses Schizoaffective disorder

Brief psychotic episode

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• Pre existing personality disorder • Female gender • Younger age of onset • Strong cultural influences on presentation • Acute onset • Duration of less than 2 months • Perplexity, confusion, rapid shifts in affect, disorganized behaviour

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Prevalence less than 1% More common in women At least one symptom of schizophrenia and one of affective disorder for at least two weeks Family history suggestive of affective disorders 20% deteriorating course