An empirical study of psychosocial and clinical correlates of delusional disorder: the DELIREMP study

Abstract

ObjectiveWe aim to describe psychosocial and clinical correlates of DD and its types. This approach is important because most knowledge on DD does not come from empirical data collected using a validated systematic research method. MethodsA cross-sectional study was conducted in a sample of 86 patients fulfilling DSM-IV criteria for DD as established using the SCID-I. Variables were evaluated using a systematic methodology and standardized instruments, and included possible psychosocial risk factors (low socioeconomic status or social isolation, immigration, sensory deficits, older age at onset), family history of psychiatric disorders and premorbid personality (SAP), psychotic psychopathology (PANSS), depressive syndrome (MADRS), global cognitive functioning (MMSE), axis I comorbidity (MINI) and other clinical aspects such as global functionality (GAF), and disability (SDI). A sociodemographic and clinical questionnaire was also completed. ResultsThe mean age at onset was 39.6 years and 61.6% of the cases were female. The most frequent DD types were persecutory (59.3%) and jealous (22.1%). Nearly 21% had a family history of schizophrenia and 17.4% had DD (significantly higher among those with the jealous subtype). Sixty-four percent had a premorbid personality disorder (38.4% paranoid, 12.8% schizoid). The grandiose type was significantly associated with higher scores on the PANSS positive subscale and the mixed type with lower scores on the PANSS negative subscale. Depression affected 45.3% of subjects (mainly mild depression) and 45.3% had hallucinations (20.9% tactile, 16.3% olfactory), which were more common among somatic cases. The mean MMSE was 27.6 (SD=2.5) suggesting a preserved cognitive function. Mean GAF was 63.9 (SD=11.3) indicating a moderate degree of disability, which was significantly worse amongst grandiose cases. ConclusionThis study provides unique empirical and reliable evidence on the real psychosocial, clinical, and psychopathological correlates of DD and its types.