269 Delusional Disorder (297.1)
DSM-IV-TR criteria
- A. Non-bizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, deceived by spouse or lover, or having a disease) of at least 1 month’s duration.
- Symptoms include:
- Nonbizarre delusions for at least one month.
- Absence of obviously odd or bizarre behavior.
- Schizoaffective Disorder and Mood Disorder with Psychotic Features have been ruled out.
- Absence of evidence that an organic factor initiated and maintained this psychotic disturbance.
- Absence of prominent hallucinations of a voice for at least one week. Absence of visual hallucinations for at least one week.
- Has never met the criteria for the active phase of Schizophrenia.
Subtypes
- B. Criterion A for Schizophrenia has never been met.
- *Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme.
- C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.
- D. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.
- E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
- Specify type (the following types are assigned based on the predominant delusional theme):
- 1. Erotomanic Type: delusions that another person, usually of higher status, is in love with the individual.
- 2. Grandiose Type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.
- 3.
- 4. Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.
- 5. Somatic Type: delusions that the person has some physical defect or general medical condition.
- 6. Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates.
- 7. Unspecified Type
Associated features
People with Delusional Disorder often appear to be very “normal” and function in many areas of their life without any difficulty. Others such as family members, coworkers, or doctors are more likely to see a problem than the person themselves.
The person with Delusional Disorder may develop a particular mood in reaction to their delusion, such as gloomy, irritated, extreme anger, or violence. One may go for unnecessary medical tests on a regular basis.
According to Kendler and Manschreck, associated factors include being married, being employed, recent immigration, low socioeconomic status, celibacy among men, and widowhood among women (Kendler, 1982; Manschreck, 2000).
Child vs. adult presentation
The onset of this disorder ranges from adolescents to adulthood but appears more frequently later in life.
The age of onset ranges from 18 t