A few empirically based studies' data on delusional disorder (DD) exist. We aim to describe sociodemographic and clinical correlates of DD and to identify clinical profiles associated to DD and its subtypes.

This is a case-register study based on all those subjects attending community mental health services within a geographically well-defined area. Four hundred and sixty-seven patients had been diagnosed as DD cases at psychiatric services serving a catchment area of some 607,494 inhabitants living in South Barcelona (Spain) during a three-year period (2001–2003). A thorough systematic review of computerised medical records was used to establish DSM-IV diagnosis, rendering a valid sample of 370 patients who fulfilled DSM-IV criteria for DD. Independent variables gathered include sociodemographic data, family and personal psychiatric history, and comorbid diagnoses on all DSM-IV axes (including GAF). We used descriptive and univariate statistical methods to explore sample frequencies and correlates across DD types.

The mean age of the patients was 55 years and the sample had a mean GAF score of 51 suggesting a poor functionality; 56.5% of the patients were female. The most frequent DD types were persecutory (48%), jealous (11%), mixed (11%) and somatic (5%), whilst 23% qualified for the NOS type. Most frequent symptoms identified were self-reference (40%), irritability (30%), depressive mood (20%) and aggressiveness (15%). Hallucinations were present in 16% of the patients (6% tactile; 4% olfactory). Nearly 9% had a family history of schizophrenia (higher among those with the jealous subtype) and 42% had a comorbid axis II diagnosis (mostly paranoid personality disorder). Depression was significantly more frequent among the persecutory and jealous types. Finally, global functioning was significantly better among jealous and mixed types and worse amongst erotomanic and grandiose cases (p = 0.008).

In the absence of other similar empirical data, this modest study provides unique empirical evidence of some clinical and risk correlates of DD and its subtypes.

Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD.

Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan’s Disability Inventory.

In the final linear regression models, higher scores in the Paranoid (β= 0.471, p <.001, r2 = 0.273) and Cognitive (β = 0.325, p <.001, r2 = 0.180) symptomatic dimensions and lower scores in verbal memory (β = −0.273, p <.05, r2 = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= −0.337, p <.01, r2 = 0.158) and executive functions (β= −0.323, p <.01, r2 = 0.094) were significantly associated with higher self-perceived disability.

Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.

Hay pocos datos publicados de estudios empíricos sobre el trastorno delirante (TD). Intentamos describir las correlaciones sociodemográficas y clínicas del TD e identificar los perfiles clínicos asociados con el TD y sus subtipos.

Éste fue un estudio de registro de casos basado en todos los sujetos que acudían a los servicios de salud mental de la comunidad en un área geográficamente bien definida. Cuatrocientos sesenta y siete pacientes habían sido diagnosticados de TD en los servicios psiquiátricos de un área de 607.494 habitantes, aproximadamente, que vivían en el Sur de Barcelona (España) durante un período de tres años (2001-2003). Se hizo una revisión sistemática cuidadosa de historias médicas computarizadas para establecer el diagnóstico de DSM-IV, obteniéndose una muestra válida de 370 pacientes que cumplieron los criterios de TD del DSM-IV. Las variables independientes recogidas fueron datos sociodemográficos, historia psiquiátrica personal y familiar, y diagnósticos de enfermedades coexistentes en todos los ejes del DSM-IV, incluido el GAF. Usamos métodos estadísticos descriptivos y univariantes para explorar las frecuencias de la muestra y las correlaciones a través de los tipos de TD.

La edad media de los pacientes era 55 años y la muestra tenía una puntuación media de GAF de 51 que indicaba baja funcionalidad; el 56,5% de los pacientes eran mujeres. Los tipos de TD más frecuentes eran persecutorio (48%), celotípico (11%), mixto (11%) y somático (5%), mientras que el 23% era del tipo no especificado (NOS). Los síntomas más frecuentes identificados fueron autorreferencia (40%), irritabilidad (30%), ánimo depresivo (20%) y agresividad (15%). Sufrían alucinaciones el 16% de los pacientes (el 6% táctiles; el 4% olfativas). Casi el 9% tenía antecedentes familiares de esquizofrenia (mayor en los del subtipo celotípico) y el 42% tenían otro diagnóstico coexistente del eje II (trastorno de personalidad, sobre todo, paranoide). La depresión era significativamente más frecuente en los tipos persecutorio y celotípico. Finalmente, el funcionamiento global era significativamente mejor en los tipos celotípicos y mixtos y peor en los tipos erotomaníaco y grandioso (p=0,008).

En ausencia de otros datos empíricos similares, este estudio limitado proporciona evidencias empíricas únicas de algunas correlaciones clínicas y de riesgo del TD y sus subtipos.