Neuropsychological Research in Delusional Disorder: A Comprehensive Review

Ibanez-Casas, Inmaculada; Cervilla, Jorge A.

doi:10.1159/000327899

Cited by 37 publications

(21 citation statements)

References 269 publications

(237 reference statements)

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“…Nevertheless, our findings might be explained by the hyper-attentiveness consistently found in DD patients [46]. This high vigilance together with the motivational need to avoid harm (errors) could be a plausible explanation for our results, and would give support to theories based on perceptive and motivational deficits in DD [5]. On the other hand, patients showed a significantly lower number of C onceptual Level Responses and Categories with very high effect sizes (Coheńs d of 2.34 and 1.80 respectively), both measures being considered as prime elements of the flexibility component within WCST.…”

Section: Discussionsupporting

confidence: 66%

“…Besides, one of the clinically defined features of DD is precisely the lack of a marked functional impairment [4]. However, very limited evidence on executive functiońs components and memory processes in DD patients exists to date, even though neuropsychological research might provide support to some of the current theories accounting for delusion formation and maintenance in DD [5].…”

Section: Introductionmentioning

confidence: 99%

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Deficits in Executive and Memory Processes in Delusional Disorder: A Case-Control Study

et al. 2013

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ObjectiveDelusional disorder has been traditionally considered a psychotic syndrome that does not evolve to cognitive deterioration. However, to date, very little empirical research has been done to explore cognitive executive components and memory processes in Delusional Disorder patients. This study will investigate whether patients with delusional disorder are intact in both executive function components (such as flexibility, impulsivity and updating components) and memory processes (such as immediate, short term and long term recall, learning and recognition).MethodsA large sample of patients with delusional disorder (n = 86) and a group of healthy controls (n = 343) were compared with regard to their performance in a broad battery of neuropsychological tests including Trail Making Test, Wisconsin Card Sorting Test, Colour-Word Stroop Test, and Complutense Verbal Learning Test (TAVEC).ResultsWhen compared to controls, cases of delusional disorder showed a significantly poorer performance in most cognitive tests. Thus, we demonstrate deficits in flexibility, impulsivity and updating components of executive functions as well as in memory processes. These findings held significant after taking into account sex, age, educational level and premorbid IQ.ConclusionsOur results do not support the traditional notion of patients with delusional disorder being cognitively intact.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Deficits in Executive and Memory Processes in Delusional Disorder: A Case-Control Study

et al. 2013

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“…Most of these studies are limited by their sample size, which might preclude detecting significant differences. Still, some evidence suggests the presence of cognitive deficits in DD similar to those found in schizophrenia, but possibly subtler [7,8,12]. This is consistent with a recent study comparing psychopathological dimensions in patients with schizophrenia, schizoaffective disorder and DD.…”

Section: Introductionsupporting

confidence: 88%

Cognition and functionality in delusional disorder

et al. 2019

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Background:Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD.Methods:Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan’s Disability Inventory.Results:In the final linear regression models, higher scores in the Paranoid (β= 0.471, p <.001, r2 = 0.273) and Cognitive (β = 0.325, p <.001, r2 = 0.180) symptomatic dimensions and lower scores in verbal memory (β = −0.273, p <.05, r2 = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= −0.337, p <.01, r2 = 0.158) and executive functions (β= −0.323, p <.01, r2 = 0.094) were significantly associated with higher self-perceived disability.Conclusions:Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.

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“…Notably, delusional disorder was more common than schizophrenia-like psychosis in this population, despite the fact that 'non-organic' delusional disorder has been found to have a relatively low lifetime prevalence in the general population [34][35].…”

Section: Clinical Presentationmentioning

confidence: 71%

Published paper

Stangeland¹,

Orgeta²,

Bell³

2017

Preprint

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Aims and objectives: A pre-registered systematic review of post-stroke psychosis examining clinical characteristics, prevalence, diagnostic procedures, lesion location, treatments, risk factors, and long-term outcomes.Background: Neuropsychiatric outcomes following stroke are common and severely impact quality of life. Previous reviews have focused on anxiety, depression and cognitive impairment in stroke but no systematic review has yet focused on post-stroke psychosis despite clear clinical need.Methods: CINAHL, MEDLINE and PsychINFO were searched for studies on post-stroke psychosis published between 1975 and 2016. Reviewers independently selected studies for inclusion, extracted data, and rated study quality.Results: Out of 2442 references, 75 met the inclusion criteria. Average age for post-stroke psychosis was 60.8 years with slightly more males than females affected. Average psychosis onset was 7.1 months after stroke. Neurological presentation was typical for stroke but a significant minority had ‘silent strokes’. The most common psychosis was delusional disorder, followed by schizophrenia-like psychosis and mood disorder with psychotic features. Mean prevalence was 4.1% (range 0.2% – 9.9%). 12 year incidence was 6.7%. Antipsychotic medication was commonly prescribed and the most frequent outcome was complete remission. Lesions were typically right hemisphere, particularly frontal, temporal and parietal regions, as well as the right caudate nucleus. Post-stroke psychosis was associated with poor functional outcomes and high mortality. Methodological quality of the studies was poor.Conclusion: Psychosis considerably adds to illness burden of stroke. Delayed onset suggests a window for early detection and intervention. Studies on the safety and efficacy of antipsychotics in this population are urgently needed.

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Neuropsychological Research in Delusional Disorder: A Comprehensive Review

Cited by 37 publications

References 269 publications

Deficits in Executive and Memory Processes in Delusional Disorder: A Case-Control Study

Deficits in Executive and Memory Processes in Delusional Disorder: A Case-Control Study

Cognition and functionality in delusional disorder

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