Delusional Disorder - Anatomy of Psych

What is delusional disorder?

Delusional disorder is a psychotic disorder characterized by the presence of at least one delusion that persists for at least 1 month. The most common delusion is persecutory delusion. The lifetime prevalence of delusional disorder is roughly 0.2%, with no significant differences between men and women.

What does delusional disorder look like?

DSM-5 Criteria

Criterion A. The presence of at least 1 delusion with a duration of at least 1 month.

Criterion B. Criterion A for schizophrenia has never been met. Note: Hallucinations, if present, are not prominent and are related to the delusional theme.

Criterion C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.

Criterion D. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.

Criterion E. The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.

Subtypes & Specifiers

Risk Factors

Immigration
Isolation
Family history
Sensory impairment
Advanced age

Prognosis

Increased risk for dementia and neurocognitive disorders if presenting in late life

How is delusional disorder treated?

Delusional disorder does not respond well to medication.

Nursing Management

See nursing management for schizophrenia.

References

[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

[2] Boyd, M. A. (2019). Psychiatric & mental health nursing for Canadian practice. Wolters Kluwer.

[3] Townsend, M. C. (2015). Psychiatric mental health nursing. F.A. Davis.