Paraphrenia: Claiming for its diagnosis

Abstract

Introduction Paraphrenia is currently considered as historical disorder. Sometimes included as paranoid schizophrenia and in many other cases as other persistent delusional disorders, its diagnosis is out of the current code list, such as ICD or DSM. Nevertheless it has unique peculiarities, already objectified by Krapelin. Objectives Claiming the concept of paraphrenia as a clinical entity with its own phenomenological characteristics included in chronic psychotic disorders. Aims To keep in mind classic psychopathology, not included in current code list, such as ICD and DSM. Methods A 40-year-old woman with good premorbid adaptation, no previous history of mental disorder. Her first psychotic symptoms appeared at 30, not because drug effect. Father diagnosed with paranoid schizophrenia. Among her first internment, her mood was persistently elevated, expansive and easily irritable. She had bizarre megalomaniac delusions of grandeur, which combined with erotomanic ideas felt as ego-syntonic, supported by auditive hallucinations. There were no other symptoms found in manic episodes in previous historical of affective descompensations. Results Antipsychotics only had effect in mood, which turned euthymic. Active psychoticism has continually been present for 10 years although different treatment. No major affective descompensations has taken place among this period. Cognitively conserved, without defectual symptoms, is currently working in supported employment. Conclusions Clinical symptoms of paraphrenia lyed between schizophrenia and persistent delusional disorders. Specifically in this case we had to do the differential diagnosis with bipolar disorder, which was ruled out attending to the longitudinal course.