The Consistency of DSM-lll·R Delusional Disorder in a First-Admission Sample

Abstract

The temporal consistency of the research diagnosis of DSM-III-R delusional disorder was assessed. Subsequent to their first psychiatric hospitalization, psychotic patients were diagnosed twice using a best-estimate procedure after 6- and 24-month follow-up. Only 57.1% of the 7 subjects diagnosed at the 6-month follow-up conference retained the diagnosis at the 24-month review. Conversely, 50.0% of the 8 subjects given this diagnosis at 24 months had different 6-month diagnoses. By contrast, 100% of a matched control group maintained the same diagnosis at both time points. Course and outcome in this sample varied considerably, with 2 of the subjects making severe suicide attempts. Longitudinal assessment in psychotic patients in their first episode is mandatory, and an initial diagnosis of delusional disorder has to be interpreted as provisional.

Early intervention in psychosis: concepts, evidence and future directions

“…While it is very stable once applied (28)(29)(30)(31), it is intrinsically difficult to apply until the patient has been ill for a prolonged period of time. Within a sample of ultra-high risk cases (already defined in order to preferentially predict transition to nonaffective psychosis), only 75% of those who go on to develop a first episode psychosis will progress to a schizophrenia diagnosis (32).…”

An Innovative Appraisal of Psychopathology in Extant Criminological Psychiatry

“…Anyhow, the exact etiology of delusional disorder is not recognized and its rare happening restricts the ability to study genetic or other risk factors [16]. Nevertheless, small family studies have failed to detect strong genetic associations between schizophrenia and delusional disorder [17].…”