Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

Abstract

Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists. Methods: A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients. Results: Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry. Conclusions: This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.

Insights into the Medical Evaluation of Ekbom Syndrome: An Overview

“…A dermatological examination must always be performed because DP can lead to different self-induced cutaneous lesions, which require additional treatment most of the time. Also, collaboration between dermatologists and psychiatrists is important for the treatment of other possible side effects of different antipsychotics, which are the first-line treatment for this pathology [103,104].…”

“…Moreover, antipsychotics can cause not only gastrointestinal symptoms but also disturbances in the levels of cholesterol, an increase in the risk of metabolic syndrome, and arrhythmias, among other possible side effects. This is another strong reason for a multidisciplinary approach to these patients, so cardiologists and internists can also be involved [103,104].…”

“…Collaboration with pharmacologists can also be helpful in monitoring antipsychotic levels to detect any possible poor response to the therapy and prevent any drug interactions [104].…”