• comorbidity;
  • delusional disorder;
  • phenomenology


  1. Top of page
  2. Abstract

Abstract  The aim of the present study was to study sociodemographic profile, clinical parameters including comorbidity, usefulness of antipsychotics especially atypicals, family history, and follow-up rates for delusional disorder. The records of all subjects who were seen in the Department of Psychiatry during a period of 10 years (i.e. 1994–2003) were reviewed. Eighty-eight subjects fulfilling the inclusion criteria were enrolled. The sample consisted predominantly of female subjects (55.7%), most of the total subjects were married and had favorable social functioning. The most common delusion was persecutory (54.5%), followed by delusion of reference (46.6%). The majority of the subjects had a comorbid psychiatric disorder. Education was negatively correlated with age at onset and positively correlated with the number of delusions. Age at onset was negatively correlated with total number of delusions. The sociodemographic profile of delusional disorder is consistent across various cultures, has high comorbidity and, when treated appropriately, responds to various antipsychotic agents.


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  2. Abstract

The diagnostic status of delusional disorder (DD) has been a subject of debate since the time of Emil Kraepelin, who developed the modern concept of paranoia.1 Earlier DD were considered to be rare but in recent years better definition and growing literature have revitalized the efforts to characterize, understand and treat these conditions. Persons with these conditions do not regard themselves as mentally ill and actively oppose psychiatric referral because they remain relatively high functioning and experience little impairment. Typically patients continue to function and live in the community without ever seeking clinical intervention and are easily misdiagnosed because they may have minimal overt identifying characteristics.2

The available studies show that patients with DD are older than schizophrenia patients at onset of illness.3–7 In one study it was also reported that age at onset differed significantly according to the type of DD, the oldest age at onset being associated with persecutory type and the youngest with the somatic type.8 Although there is no consensus, most of the studies have reported that female subjects outnumber male subjects at first admission in DD,3,6,8,9 DD patients in general are more poorly educated than patients with affective illness,6 and have a satisfactory work history as compared to schizophrenia patients.5 In the only meta-analysis of data available on DD, it was found that female subjects outnumbered male subjects in the proportion of 3:2; the mean age of female subjects was greater than that of male subjects at the time of case identification; celibacy was common especially in male subjects and widowhood was high in female subjects. A positive family history of psychiatric disorder was found in 18.7% of patients but this was regarded as a gross underestimation because of incomplete reporting. A combination of organic brain disorder and/or alcohol or substance abuse was relatively more common among male than female subjects.10

Studies regarding outcome of DD,4,5,9,11–15 which have been carried out for sample sizes varying from nine to 163 subjects using various diagnostic criteria, with follow up of up to 20 years, have shown that 3–28% of cases are re-diagnosed as schizophrenia, 3–8% of cases are re-diagnosed as affective illness, and in the remainder of the sample the diagnosis was stable. Stephens et al. found that poor follow up was significantly correlated with reclusive personality, poor premorbid history, onset ≥6 months before admission, gradual onset, lack of insight, single marital status and lack of precipitating factor.15

Much of the literature on treatment of DD is in the form of case reports or very small series.16 The most promising development in the management of DD is the introduction of the oral neuroleptic pimozide, which has been used successfully in a number of cases. In a meta-analysis that reviewed approximately 1000 articles on paranoia/DD from 1961 onwards and selected 257 cases as per DSM-IV Criteria, it was reported that quality of information available was poor. Because of poor quality of much of the information obtained, Munro and Mok divided the available information into broad categories of response to treatment, that is, ‘recovery’, ‘partial recovery’, ‘no improvement’ and, where applicable, ‘non-compliance’. Munro and Mok found that before 1980 a variety of neuroleptics were used in the treatment, but since 1980 pimozide was the single most common drug of choice. Adequate treatment details were available in 209 subjects, of whom 110 (52.6%) had recovery, 59 (28.2%) had partial recovery, and no improvement was noted in 40 subjects (19.2%). When Munro and Mok analyzed the data in relation to pimozide, they found that 68.5% were judged to have recovered fully and 22.4% partially, making a total of approximately 91% with a greater or lesser degree of improvement. This was in contrast to 68% overall greater or lesser degree of improvement (22.6% had full recovery and 45.3% had partial recovery), and the difference between the two groups was significantly in favor of pimozide (P = 0.001).10 Beneficial effects have also been found for risperidone.17,18 From India, authors have reported good response to antipsychotics such as trifluperazine, haloperidol, chlorpromazine; and electroconvulsive therapy. Eleven out of 19 patients with delusional parasitosis had complete remission, five of them maintaining the recovery for >3 years.19

Various studies that have compared DD with schizophrenia have shown that the two disorders differ in psychopathological characteristics, sociodemographic variables, and course and treatment outcome.20–22 However, most of the studies available have not addressed the issue of comorbidity and use of atypical antipsychotics in DD. The aim of the present study was to study the sociodemographic variables, clinical parameters including comorbidity, effectiveness of antipsychotics especially atypicals, family history, and follow up rates of DD.


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  2. Abstract

The present study was a retrospective chart review in which records of all subjects diagnosed as having DD according to ICD-10 criteria23 were assessed for sociodemographic, clinical and treatment variables.

The case files of patients who attended the Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh during the period 1994–2003 were reviewed. This department is a general hospital psychiatric unit with inpatient and outpatient facilities in a tertiary care, multidisciplinary teaching hospital. All patients are routinely assessed through a detailed semistructured interview. Information is elicited from the patients and their attendants who are related to or are well known to the patient and are involved in caregiving. The initial information is documented in the case files by a trainee psychiatrist in detail and is confirmed by the consultant in charge of the case. In subsequent visits (which are usually every 4–6 weeks) to the outpatient unit and/or during admissions to the inpatient unit, new information is added to the same case file. All the psychiatric diagnoses (primary and comorbid) are based on ICD-10.23

A total of 18 000 files were screened for ICD-1023 diagnosis of DD, out of which 146 patients were diagnosed as having DD, of whom detailed information was available for 88 subjects. These case files used in the study. Information regarding patients' psychiatric and medical histories, course of illness and response to treatment was derived from information recorded in the patient case notes. All this information was gathered according to the structured proforma devised by the authors for the purpose of the study. Operationalized definitions were made specifically for the current study to assess the drug compliance, treatment response and status of follow up. Drug compliance was assessed according to the descriptions in the records as ‘poor’ (those taking <25% of the drugs during the contact period), ‘average’ (those taking 25–75% of the prescribed drugs during the contact period) and as ‘good’ (those taking >75% of the prescribed drugs during the contact period).

Treatment response was assessed for patients who received antipsychotics ≥300 mg chlorpromazine (CPZ) equivalent for at least 12 weeks. The response was divided into ‘poor’ (reduction of symptoms by <25%), ‘partial’ (reduction of symptoms of 25–50%) and ‘good’ (>50% reduction of symptoms). Follow-up status was divided into following up ‘regularly’, following up ‘irregularly’ and ‘drop out’. Those patients who kept >50% of their scheduled visits during their period of contact were considered to be following up regularly. Those who kept <50% of the scheduled visits during the period of contact were classified as following up irregularly. Those patients who did not follow up even once in the year prior to the intake for the present study were classified as drop-outs. In the chart review it was found that for no subject was the treatment terminated by the treating team. The lag period was defined as time lag between the onset of illness and the first treatment contact. Duration of illness was defined as time between onset of illness and age at presentation (i.e. when they were first registered in the PGIMER walk-in clinic). The total duration of contact was the duration for which the patient was followed up at PGIMER (outpatient and/or inpatient).

Descriptive statistics in terms of percentage were used for categorical variables such as sociodemographic characteristics and clinical characteristics. Mean ± SD was calculated for the continuous variables. For comparison t-test, Mann–Whitney U-test, χ2 test, and Fisher exact test were used. The relationship between sociodemographic variables and clinical characteristics was ascertained using Pearson correlation coefficient (r), point biserial correlation (rpb) and Spearman's rho correlation (ρ). The study protocol was approved by the departmental ethical committee at PGIMER.


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  2. Abstract

Sociodemographic features

The sample (n = 88) consisted of 39 men (44.3%) and 49 women (55.7%). The majority of the subjects were married (70.4%), employed (47.7%) or housewives (39.8%), were educated below matric (63.6%), had monthly income of more than Indian Rupees 4000 (approx. 100 dollars) (61.4%), hindu by religion (68.2%), belonged to nuclear family (53.4%), and were from an urban background (68.2%).

The mean age of onset was 37.90 ± 15.33 years and mean age at first contact with a psychiatrist was 41.78 ± 15.16 years (range, 19–94 years). Precipitating factor could be identified in only 39.8% of cases and few subjects (9.1%) had an episodic illness. The mean duration of contact with the treating agency was 24.62 ± 35.68 months (range, 0.25–180 months), with the average number of visits being 12.97. Most of the subjects had dropped out (68.2%) by the time of the study.

Clinical profile

The most common delusion was persecutory (54.5%), followed by referential (46.6%), hypochondriacal (30.7%), infidelity (28.4%) and parasitosis (17.0%). Only one subject had a delusion of love and one had grandiose delusion. Many subjects had more than one delusion and the mean number of delusions was 1.80 ± 0.73 (range, 1–4).

Most of the subjects were treated with only antipsychotics (61.4%), and approximately one-third of patients (36.4%) were treated with a combination of antipsychotic and antidepressants. Eighty percent of the patients had good or average compliance (good, 38.6%; average, 42%) with medication. Only 18.2% had good response and 42% had partial response to antipsychotics. Few patients had a change of antipsychotics because of poor response. Only one-fourth of patients experienced side-effects. The mean dose of antipsychotics prescribed was 414.53 mg chlorpromazine equivalent, which was calculated as per Richelson.24 Results are given in Table 1.

Table 1.  Clinical profile
VariablesTotal sample (n = 88) Mean ± SD (range)Comorbidity present (n = 57)Comorbidity absent (n = 31)Comparative statistics
  • *

     P < 0.05.

  • Lag period, duration between onset and first treatment contact.

  •  Mann–Whitney U-test;

  •  χ2 test;

  • §

     χ2 test with Yates correction;

  •  Fisher exact two-tailed test.

  • ††

     Substance dependence, n = 8; psychotic illness, n = 15; affective illness, n = 5; obsessive–compulsive disorder, n = 3.

  • ‡‡

     Schizophrenia, n = 4; bipolar affective disorder, n = 1; recurrent affective disorder, n = 1.

  • EPS, extrapyramidal syndrome; TD, tardive dyskinesia.

Age at first presentation (years)41.78 ± 15.16 (19–94) 41.10 ± 12.7848.24 ± 19.28t = −2.08*, d.f. = 86, P = 0.040
Age at onset (years)37.90 ± 15.33 (17–69.5)35.39 ± 13.7742.20 ± 17.65t = −2.00*, d.f. = 86, P = 0.049
Lag period (years)03.98 ± 6.01 (0–36)04.64 ± 7.012.77 ± 3.27U = 822, z = −0.542, P = 0.16
Total duration of contact in hospital (months)24.62 ± 35.98 (0.25–180)30.43 ± 39.2713.93 ± 25.84U = 614.5*, z = −2.37, P = 0.018
Average no. visits to hospital12.97 ± 15.57 (2–70)23.57 ± 72.699.45 ± 12.87U = 597*, z = −2.50, P = 0.012
Precipitating factorn (%)   
 Present35 (39.8)24110.368 (P = 0.544)
 Absent53 (60.2)3320 
 Continuous80 (90.9)51290.061 (P = 0.805)§
 Episodic08 (09.1)0602 
Persecutory Delusion
 Present48 (54.5)33150.732 (P = 0.392)
 Absent40 (45.5)2416 
Grandiose Delusion
 Present01 (01.1)01001.000
 Absent87 (98.9)5631 
Delusion of Reference
 Present41 (46.6)29121.195 (P = 0.274)
 Absent47 (53.4)2819 
Delusion of infidelity
 Present25 (28.4)23029.74 (P = 0 .002)§
 Absent63 (71.6)3429 
Hypochondriacal delusion
 Present27 (30.7)17100.056 (P = 0.813)
 Absent61 (69.3)4021 
Delusion of parasitosis
 Present15 (17.0)05106.26 (P = 0.012)§
 Absent73 (83.0)5221 
Family history of mental illness††
 Present31 (35.2)21100.816
 Absent57 (64.8)3621 
Compliance (%)
 <25%15 (17.0)09061.771 (P = 0.412)
 25–75%37 (42.0)2710 
 >75%34 (38.6)2014 
Response to antipsychotics
 Poor31 (35.2)1714NA
 Partial37 (42.0)2611 
 Good16 (18.2)1204 
 Cannot be commented02 (02.3)0101 
 Antipsychotic only54 (61.4)2727NA
 Antipsychotic antidepressant32 (36.4)2803 
 Antidepressant only02 (02.2)0201 
Current status of follow-up
 Drop out60 (68.2)34265.90 (P = 0.52)
 Still following up16 (18.2)1402 
 Irregular follow up12 (13.6)0903 
Type of antipsychotic given
 Pimozide30 (34.1)1515NA
 Risperidone20 (22.7)1505 
 Olanzapine13 (14.8)0904 
 Other typical antipsychotics18 (20.5)1404 
 Other atypical antipsychotics02 (02.3)0002 
 Atypical + typical antipsychotics03 (03.4)0300 
 EPS09 (10.2)0504NA
 TD07 (08.0)0403 
 Significant weight gain04 (04.5)0400 
 Hypotension01 (01.1)0100 
Change of antipsychotics
 Yes17 (19.4)10070.327 (P = 0.568)
 No61 (80.6)4724 
Change of diagnosis‡‡
 Yes06 (06.8)04021.000
 No82 (93.2)5329 

Pimozide (n = 30) was the most commonly prescribed antipsychotic, other commonly prescribed antipsychotics were risperidone (n = 20) and olanzapine (n = 13; Table 2). Best response was seen with risperidone (35% had good response and 45% had partial response) followed by pimozide (13.33% had good response and 43.33% had partial response), although patients on pimozide had better compliance compared to those on risperidone (Table 3).

Table 2.  Compliance with antipsychotics
Drugs (No. subjects)Poor (<25%)Partial (25–75%)Good (>75%)
Pimozide (30)31413
Risperidone (20)497
Olanzapine (13)463
Other atypical antipsychotics (2)110
Typical antipsychotics (18)369
Combination of two antipsychotics (3)012
Table 3.  Response to antipsychotics
Drugs (No. subjects)PoorPartialGoodCannot be commented
Pimozide (30)121341
Risperidone (20)4970
Olanzapine (13)6700
Other atypical antipsychotics (2)2000
Typical antipsychotics (18)7641
Combination of two antipsychotics (3)0210


The majority of the subjects (64.8%) had a comorbid psychiatric illness with depressive disorders being the most common (53.5%). Other comorbid conditions included alcohol dependence (3.4%) marital discord (6.8%) and history of mania (n = 1; 1.1%). Only 35.2% of subjects had a family history of psychiatric illness. The most common disorder in family members included psychotic disorder (17%) followed by substance dependence (9.9%), affective illness (5.61%) and obsessive–compulsive disorder (3.4%).

The sample was divided into two groups on the basis of presence or absence of comorbid depression. No statistically significant difference was found between the two groups on sociodemographic factors, clinical and outcome factors. However, when we divided the sample into two groups based on presence or absence of psychiatric comorbidity significant difference was seen in subjects with and without comorbidity on marital status and type of family. Significantly more number of subjects with comorbidity were married (Pearson's χ2 = 8.162; d.f. = 1, P = 0.004) and came from nuclear families (Pearson's χ2 = 4.156; d.f. = 1, P = 0.041). Similarly for clinical variables, when we compared the two groups the patients with delusion of infidelity had significantly higher prevalence of comorbidity (Pearson's χ2 with Yate's continuity correction: 9.74; d.f. = 1, P = 0.002), whereas patients with delusion of parasitosis had significantly lower prevalence of comorbidity (Pearson's coefficient with Yate's continuity correction: 6.26; d.f. = 1, P = 0.012). Patients with comorbidity were also younger at first presentation, had earlier age at onset, and had longer duration of contact with the treating agency (Table 1).

Correlation analysis

Correlation between various sociodemographic and clinical variables was done using Pearson's correlation coefficient, Spearman's rho, and point biserialcorrelation as required. Education had negative correlation with age at onset (point biserial correlation coefficient: −0.482, P = 0.001) and positive correlation with number of delusions (point biserial correlation coefficient: 0.246, P = 0.036). Age of onset had negative correlation with total number of delusions (Pearson' correlation coefficient: −0.255, P = 0.017), duration of illness at presentation (Spearman's ρ = −0.350, P =0.001). Duration of contact with treating agency was longer in subjects with a higher number of delusions (Spearman's ρ = 0.254, P = 0.017) and longer duration of illness before first presentation (Spearman's ρ =0.218, P = 0.041).

Age of onset was lower in subjects with delusion of reference (point biserial correlation coefficient: −0.265, P = 0.013), but it was higher for subjects with delusion of parasitosis (point biserial correlation coefficient = 0.271, P = 0.011). Similarly age at first presentation was also lower for subjects with referential delusions (point biserial correlation coefficient: −0.211, P = 0.048) and delusion of infidelity (point biserial correlation coefficient: −0.222, P = 0.037). Subjects with delusion of parasitosis had higher age of onset (point biserial correlation coefficient: 0.270, P = 0.011) and shorter duration of illness at presentation. Patients with delusion of reference had longer duration of illness at presentation (Spearman's ρ = 0.251, P = 0.018). In contrast patients with delusion of parasitosis had shorter duration of illness at presentation (Spearman's ρ =−0.293, P = 0.006). Patients with delusion of infidelity had poor drug compliance (Spearman's ρ = −0.231, P = 0.033). Further significant correlation also emerged between presence of comorbity and number of delusions (Spearman's ρ = −0.221, P = 0.039). There was no statistically significant correlation between response to treatment, sociodemographic variables, and dose of antipsychotics.


  1. Top of page
  2. Abstract

The present study was retrospective in nature and was designed to evaluate the sociodemographic variables, clinical profile, family history, treatment variables and follow-up rates of DD patients.

Sociodemographic variables

The present study showed that there was a female preponderance. Similar trends were seen in an earlier study8 and the meta-analysis.10 The aforementioned findings suggest that DD is more common in female subjects, unlike in schizophrenia for which there is an equal gender distribution. Previous studies have shown that the majority of patients with DD are married, self-supporting (79%) and had no major period without work (79%).4 Findings in the current study were similar. The possible reasons for this could be that the patients with DD experience little impairment and hence are able to carry out their occupational responsibilities. Further, the mean age of onset in the current study was approximately 38 years, therefore it was more likely that they would have been married and would have completed their formal education. In contrast to an earlier study, which had shown that subjects with DD belong to low socioeconomic status,6 in the present study the majority of the subjects belonged to middle to higher socioeconomic status. This could possibly be due to a higher percentage of patients being functional and earning or a mere reflection of the sample of patients attending a tertiary care hospital.

Clinical profile

Previous studies have shown that the mean age of onset of DD was 42.4 years7 and in the majority of patients onset is between 34 and 45 years.6 The present findings are similar (mean age of onset, 37.9 years). In the present study the mean age at first contact with a treating agency was 41.77 years, meaning that there was a time lag of 3.87 years before treatment was sought. The course was continuous in the majority of the cases (91%), signifying that DD definitely runs a different course compared to affective disorders. Diagnosis was changed in only six cases (7%), which meant that the diagnosis of DD is reasonably stable over a long time as reported in the past.4,5 Almost two-thirds of the patients dropped out of follow up by the time of the study, suggesting that DD patients did not consider themselves as ill, resist treatment and possibly continue to have a reasonable level of functioning.


The majority of the subjects had more than one delusion occurring together. The persecutory, referential and hypochondriacal delusions were the most common delusions whereas grandiose delusions and erotomanic delusions were relatively uncommon. But this distribution of the type of delusions should be interpreted in the light of effects of the same on the patient and their family. The aforementioned findings probably suggest that persecutory and referential delusions not only lead to distress in subjects suffering from the same, but also lead to distress in the family and as a result subjects with such delusions are persuaded to seek treatment.

In the only meta-analysis of data available on DD, positive family history of psychiatric disorder was found in 18.7% of patients but this was regarded as gross underestimation because of incomplete reporting.10 We found that 35.2% of subjects had a family history of psychiatric illness. Approximately one-fourth of the patients had a positive family history of substance dependence, which gives credence to the finding of Kendler and Walsh25 who reported some relationship between DD and alcoholism.


Review of the literature suggests that comorbidity has not been the focus of study in DD subjects. High prevalence of comorbid psychiatric disorders (65%) in the present study indicates that the patients with DD should be evaluated for the same and treated adequately.

Maina et al. also reported comorbidity at 72% in their study and asserted that psychiatric comorbidity is a relevant phenomenon in DD as in other psychotic disorders.26 In the present study too, one of the important findings was high prevalence of comorbid psychiatric diagnosis. Further, the high prevalence of comorbid depression (54.5%) in the present sample is similar to the 50.7–53.1% reported in previous studies.26,27 Presence of significant correlation between number of delusions and comorbidity suggests that a higher number of delusions predisposes to development of a comorbid diagnosis, especially depression. Another way of understanding high comorbidity of depression in DD is to consider depression as part of the symptomatology of DD, as studied by Serretti et al.28 They factor analyzed the symptomatology of DD and reported four factors: depression; hallucination; delusions; and irritability; with depression emerging as the first factor and explaining 20% of the total variance. Further, the present results also suggest that patients with comorbidity have earlier age of onset, are younger at first presentation and remain for longer in the treatment net, which is in similar to that reported by Maina et al.26

Treatment variables

Approximately two-thirds of patients were treated with antipsychotics alone and one-third with a combination of antidepressants and antipsychotics. As discussed earlier, the reason for this could be high prevalence of accompanying depression. However, in the background of the total prevalence of comorbid depression, only a minority of the subjects with depression received antidepressants. This probably shows the tendency of clinicians not to treat depression in the presence of psychosis and consider it to be part of the same.

Pimozide was the most common antipsychotic used, followed by risperidone and olanzapine. This was most likely due to the common acceptable notion in the early 1990s that pimozide is specifically useful in cases of DD. However, over the years, due to the availability of newer relatively safer atypical antipsychotics and experience that pimozide is not as effective and specific as considered earlier, atypical antipsychotics have come to be used more frequently. High prevalence of use of atypical agents probably indicates a shift of practising psychiatrists to prescribe atypical antipsychotics for DD. The response to risperidone was the best among antipsychotics, followed closely by pimozide. Good response to risperidone suggests that further randomized trials for newer agents are required in DD. If more evidence accumulates in favor of the atypical antipsychotics, especially risperidone, it will be a step ahead in the treatment of DD. Authors from India found good response to antipsychotic treatments using trifluperazine, haloperidol and chlorpromazine, as well as electroconvulsive therapy.19 In the present sample 18 subjects were treated with typical antipsychotics other than pimozide, out of which four qualified for good response and six as partial responders. From this it can be concluded that, as claimed previously, DD may not respond specifically to pimozide alone. Compliance with treatment is much more encouraging in the present study, contrary to the previous reports of poor compliance in patients with DD, and it may be due to the cultural influence in the form of better family bonding in Indian subjects, leading to good supervision of medication. Other factors that could have contributed to high drug compliance may be high prevalence of delusions of hypochondriasis and parasitosis (in which patients usually consider themselves to be having distressing experiences) in approximately 50% of the subjects, and lack of minimal side-effects because of greater tendency to use atypical agents.

Correlation analysis

The negative correlation of education with age at onset and a positive correlation with number of delusions meant that individuals with higher education develop the illness at a younger age and were more likely to have a higher number of delusions as compared to less educated individuals. Varma et al. reported that higher educated individuals have high levels of linguistic competence, and hence are able to bind their anxiety levels in the form of psychopathology.29 The same reason can explain the higher number of delusions in more educated subjects. Positive correlation between total duration of contact with number of delusions and duration of illness reflects the severity and need for treatment.

Delusions of reference and infidelity were seen with younger age of onset whereas somatic delusions and delusional parasitosis occurred more in older age patients. This is similar to the findings in the Yamada et al. study.8 Delusions of reference and infidelity probably lead to more distress to the spouses and caregivers, which could have led to their early detection. Delusional parasitosis, which was more common in the older age group patients, was associated with a shorter lag period. In contrast, delusion of persecution had a longer duration of illness at presentation and longer lag period. These differences suggest that level of insight, and distress to the patient and their family members are the most important factors determining the need for treatment. However, it must be appreciated that in most of the correlations the correlation coefficients were relatively low, hence further studies are required to validate the present findings.


Although the present study had a relatively large sample size it was limited by the fact that it was retrospective in nature, the sample was drawn from a hospital-based clinic, there was a lack of a comparative group and some of the treatment variables were not assessed systematically.


  1. Top of page
  2. Abstract

Delusional disorder is unique in its own right and has a sociodemographic profile that is similar across various cultures. It has high comorbidity and if treated appropriately responds to various antipsychotics. High comorbidity with affective disorders, response to a combination of antipsychotics and antidepressants and an equal family history of psychotic and affective disorders points towards a subgroup of DD, more akin to affective disorders. It may be worthwhile to further investigate this subgroup and use more appropriate treatment strategies for its management.


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  2. Abstract
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