Background. Most of the existing studies suggest that suicide is one of the leading causes of premature death in patients with chronic psychotic disorders. However, very few studies have specifically investigated suicidal behaviour in patients with delusional disorder. Thus, our objective was to review the literature regarding the percentage of lifetime ideation and suicidal behaviour in delusional disorder in order to provide suggestions for clinical practice. Methods. MEDLINE and PsycINFO were searched from January 1980 to September 2012 using the following keywords: delusional disorder, paranoia, suicidal ideation, and suicidal behaviour. Results. A total of 10 studies were identified and included in the review. The percentage of suicidal behaviour in delusional disorder was established between 8 and 21%, which is similar to schizophrenia. Suicidal ideation and suicide attempts were more frequent in patients showing persecutory and somatic delusions in the reviewed studies. Conclusions. To the best of our knowledge this is the first attempt to specifically review the suicide phenomenon in patients with delusional disorder. Interestingly, our results support the notion that percentages of both suicidal ideation and behaviour in delusional disorder are similar to patients with schizophrenia.

-Background and Objectives:In clinical practice, the coexistence of delusions and affective symptoms is often observed. The current Diagnostic and Statistical Manual of Mental Disorders, fourth edition-Text Revision (DSM-IV-TR) accepts the existence of mood disturbances in delusional disorder. Little research has been done regarding this field and prevalence rates are unclear. Our purpose was to review the frequency of affective symptoms in delusional disorder patients and to identify the proportion of these patients that are reported to be treated with antidepressants.Methods: Three electronic databases were searched from 1980 to July 2012: MED-LINE, PsycINFO and PubMed, using the following keywords: delusional disorder, depression, affective illness, antidepressants and paranoia.Results: A high frequency of affective disturbances was found in this population (21-55.8%). In contrast, a low antidepressants prescription rate was shown. When focusing on delusional disorder somatic subtype, a particularly high mood disorder comorbidity rate was described and a good efficacy of antidepressant drugs was reported, in monotherapy or in combination with antipsychotics. ALEXANDRE GONZÁLEZ-RODRÍGUEZ ET AL. Background and objectives

Objective: To compare the efficacy and tolerability of paroxetine and mirtazapine in the treatment of major depression. Data sources: Searches were conducted to identify studies through Medline (1980-2011), PsycInfo (1980-2011 and PubMed databases up to June 2011. The searches were not restricted to publication type or clinical trial design. Study selection: A clinical trial was included if it described a trial of paroxetine versus mirtazapine in patients with major depression, based on the research evidence of reviews. Data abstraction: Three assessors analyzed the quality of the trials and extracted study design data, trial features, efficacy and tolerability assessment tools, discontinuation reasons for both antidepressants and remitter and responder rates. Results: We included six randomized controlled trials, one open-label, randomized controlled trial and four systematic reviews and metaanalysis. Rates of remission and response between mirtazapine and paroxetine were compared: at the beginning (1-2 weeks) there were statistically significant differences in mirtazapine treated patients, but these were not found at the end of assessment period (6-8 weeks). Discontinuation rates between the two drugs showed no differences, with an adverse event profile characteristic of each drug. Conclusions: Mirtazapine and paroxetine were equally effective and well-tolerated in major depressive disorder. Differences in effectiveness were only observed in the first or second week of treatment when mirtazapine showed earlier onset of action.