Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-19T06:50:32.926Z Has data issue: false hasContentIssue false
  • English
  • Français

Delusional disorder and schizophrenia: a comparative study across multiple domains

Published online by Cambridge University Press:  29 July 2016

V. Peralta  and
M. J. Cuesta
V. Peralta*
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
M. J. Cuesta
Affiliation:
Instituto de Investigación Sanitaria de Navarra (IdisNa)Pamplona, Spain
*
*Address for correspondence: Dr V. Peralta, Department of Psychiatry, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008 Pamplona, Spain. (Email: victor.peralta.martin@cfnavarra.es)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Delusional disorder (DD) is an under-researched condition and its relationship to schizophrenia (SZ) controversial. This study aimed to further characterize DD and to examine multi-domain evidence for the distinction between DD and SZ.

Method

Using univariate analyses we examined 146 subjects with DD, 114 subjects with paranoid SZ and 244 subjects with non-paranoid SZ on 52 characteristics from several domains including demographics, risk factors, premorbid features, illness characteristics, index episode features, delusional-related features, response to treatment and outcome. In a further step, we searched for independent associations of the examined characteristics with DD v. SZ.

Results

Univariate analyses showed that DD differed from either form of SZ in 40 characteristics, the pattern of findings indicated that paranoid SZ was much more similar to non-paranoid SZ than DD. Relative to subjects with SZ, those with DD were more likely to have drug abuse before illness onset, better premorbid sexual adjustment, later age at illness onset, higher levels of affective symptoms and lack of insight, poorer response to antipsychotic medication, better functioning in the domains of personal care, paid work and social functioning; last, subjects with DD had fewer but more severe delusions and higher ratings of conviction of delusional experience than those with SZ. Predominance of jealousy and somatic delusions was confined to subjects with DD.

Conclusions

DD and SZ represent two distinct classes of disorders, the differential features of DD being of nosological, aetiological and therapeutic relevance.

Keywords

Delusional disorderdiagnosisnon-paranoid schizophrenianosologyparanoid schizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 13 , October 2016 , pp. 2829 - 2839
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N (1987). Comprehensive Assessment of Symptoms and History (CASH). University of Iowa College of Medicine: Iowa.Google Scholar
Andreasen, NC, Endicott, J, Spitzer, RL, Winokur, G (1977). The family history method using Research Diagnostic Criteria. Archives of General Psychiatry 34, 229–1235.CrossRefGoogle Scholar
APA (1987). Diagnostic and Statistical Manual for Mental Disorders, 3rd edn revised. American Psychiatric Association: Washington, DC.Google Scholar
APA (1994). Diagnostic and Statistical Manual for Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Ben-Zeev, D, Morris, S, Swendsen, J, Granholm, E (2011). Predicting the occurrence, conviction, distress and disruption of different delusional experiences in daily life of people with schizophrenia. Schizophrenia Bulletin 38, 826–837.Google Scholar
Bentall, RP, Rowse, G, Shryane, N, Kinderman, P, Howard, R, Blackwood, N, Moore, R, Corcoran, R (2009). The cognitive and affective structure of paranoid delusions. Archives of General Psychiatry 3, 236–247.CrossRefGoogle Scholar
Berner, P, Gabriel, E, Shanda, H (1980). Nonschizophrenic paranoid syndromes. Schizophrenia Bulletin 6, 627–632.CrossRefGoogle ScholarPubMed
de Portugal, E, Gonzalez, N, del Amo, V, Haro, JM, Díaz-Caneja, CM, Luna del Castillo, JdD, Cervilla, JA (2013). Empirical redefinition of delusional disorder and its phenomenology: the DELIREMP study. Comprehensive Psychiatry 54, 243–255.Google Scholar
de Portugal, E, Gonzalez, N, Haro, JM, Autonell, J, Cervilla, JA (2008). A descriptive case-register study of delusional disorder. European Psychiatry 23, 125–133.Google Scholar
Freeman, D, Dunn, G, Startup, H, Pugh, K, Cordwell, J, Mander, H, Cernis, E, Wingham, G, Shirvel, K, Kingdom, D (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. Lancet Psychiatry 2, 305–313.CrossRefGoogle Scholar
Gabriel, E (1987). Dysphoric mood in paranoid psychoses. Psychopathology 20, 101–106.CrossRefGoogle ScholarPubMed
Guy, W (1976). ECDEU. Assessment Manual for Psychopharmacology. NIMH Psychopharmacology Research Branch, Department of Health Education and Welfare: Rockville, MD.Google Scholar
Guy, W, Ban, TA (1982). The AMDP-System. Springer: Heidelberg, Germany.Google Scholar
Hui, CLM, Lee, EHM, Chang, WC, Chan, SKW, Lin, J, Xu, JK, Chen EY, (2015). Delusional disorder and schizophrenia: a comparison of neurocognitive and clinical characteristics in first-episode patients. Psychological Medicine 45, 3085–3095.CrossRefGoogle ScholarPubMed
Kendler, KS (1980). The nosology validity of paranoia (simple delusional disorder). Archives of General Psychiatry 37, 699–706.Google Scholar
Kendler, KS (1982). Demography of paranoid psychosis (delusional disorder). Archives of General Psychiatry 39, 890–902.Google Scholar
Kendler, KS (1990). Toward a scientific psychiatric nosology. Strengths and limitations. Arch General Psychiatry 47, 969–973.CrossRefGoogle Scholar
Kendler, KS, Glazer, WM, Morgenstern, H (1983). Dimensions of delusional experience. American Journal of Psychiatry 140, 466–469.Google ScholarPubMed
Kraepelin, E (1921). Manic-Depressive Insanity and Paranoia. Livinstone Press: Edinburgh, England.Google Scholar
Lewis, SW, Murray, RM (1987). Obstetric complications, neurodevelopmental deviance and risk of schizophrenia. Journal of Psychiatric Research 21, 413–421.Google Scholar
Marneros, A, Pillmann, F, Wustmann, T (2012). Delusional disorders. Are they simply paranoid schizophrenia? Schizophrenia Bulletin 38, 561–568.Google Scholar
Mizrahi, R, Kiang, M, Mamo, DC, Arenovich, T, Bagby, RM, Zipursky, RB, Kapur, S (2006). The selective effect of antipsychotics on the different dimensions of the experience of psychosis in schizophrenia spectrum disorders. Schizophrenia Research 88, 111–118.Google Scholar
Munro, A (1988). Delusional (paranoid) disorders. Canadian Journal of Psychiatry 33, 399–404.CrossRefGoogle ScholarPubMed
Opjordsmoen, S, Retterstöl, N (1991). Delusional disorder: the predictive validity of the concept. Acta Psychiatrica Scandinavica 84, 250–254.Google Scholar
Perälä, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsä, E, Pirkola, S, Partonen, T, Tuulio-Henriksson, A, Hintikka, J, Kieseppä, T, Härkänen, T, Koskinen, S, Lönnqvist, J (2007). Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64, 19–28.CrossRefGoogle ScholarPubMed
Peralta, V, Cuesta, MJ (2003). The nosology of psychotic disorders: a comparison among competing classification systems. Schizophrenia Bulletin 29, 413–425.CrossRefGoogle ScholarPubMed
Peralta, V, Cuesta, MJ (2016). Delusional disorder and schizophrenia: a comment on Hui et al . Psychological Medicine 46, 1559–1160.Google Scholar
Peralta, V, Moreno-Izco, L, Calvo-Barrena, L, Cuesta, MJ (2013). The low- and higher-order factor structure of symptoms in patients with a first-episode of psychosis. Schizophrenia Research 147, 116–124.Google Scholar
Sham, PC, MacLean, CJ, Kendler, KS (1994). A typological model of schizophrenia based on age at onset, sex and familial morbidity. Acta Psychiatrica Scadinavica 89, 135–141.Google Scholar
Tewissen, V, Bentall, RP, Oorshot, M, Campo, A, van Lierop, T, van Os, J, Muin-Germeys, I (2011). Emotions, self-esteem, and paranoid episodes: an experience sampling study. British Journal of Clinical Psychology 50, 178–195.CrossRefGoogle Scholar
Van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179–195.Google Scholar
WHO (1988). WHO Psychiatric Disability Assessment Schedule (WHO/DAS). World Health Organization: Geneva.Google Scholar
Winokur, G (1977). Delusional disorder (paranoia). Comprehensive Psychiatry 18, 511–521.CrossRefGoogle ScholarPubMed
Wustmann, T, Pillmann, F, Friedemann, J, Piro, J, Schmeil, A, Marneros, A (2012). The clinical and sociodemographic profile of persistent delusional disorder. Psychopathology 45, 200–202.Google Scholar