Epidemiological studies on delusional disorder (DD) have shown that it is more frequent in women than in men. Women become ill later and the majority of them have lower social functioning at admission and more duration of the hospitalization.

Describe a sample of 78 inpatients on DD and performance in follow-up.

To perform a description and analysis of gender-related features in DD.

We included all consecutive cases of DD inpatients, fulfilling the DSM-IV-TR criteria, at the Department of Psychiatry (Hospital Clinic-Barcelona), from 2000 to 2011. We recorded sociodemographic data, clinical features at index admission, pharmacological treatment use and adherence to follow-up after discharge for the first year. for comparison purposes, Mann-Whitney U and Chi-square tests were used.

Seventy four per cent were women, mean age (SD) 61.27 years (13.08). the most common delusional ideas were persecutory delusions (74.4%). Women were admitted more frequently due to behavioral and thought disorders (p = 0.011). Women became ill later than men (50.05 vs 46.45 years; p=ns). Age at first admission was higher in women (56.71 vs 51.55), not significantly. Duration of hospitalization was longer in women (p=0.045), they received more antidepressants (p = 0.029) and showed less compliance during the first six months (38% vs 17.6% dropped-outs). There were no differences in the mean period between the first and the second admission.

There are gender differences in DD in age at onset, at first admission and duration of hospitalization. Women need more pharmacological treatments but show less compliance at follow-up.