The present study investigated the occurrence and the clinical correlates of psychiatric co-morbidity in a sample of 64 patients with delusional disorder (DD). Subjects were evaluated with a semi-structured interview for the collection of demographic and clinical features of the disorder; co-morbid axis 1 disorders were determined according to the clinical interview using DSM-IV by Othmer and Othmer. Delusional disorder subjects with and without co-morbid diagnoses were compared to investigate whether the presence of another psychiatric disorder influenced the clinical features of the illness.Seventy-two percent of the subjects had at least one additional lifetime psychiatric diagnosis. High lifetime co-morbidity was found with affective disorders, whose onset generally had been subsequent to the onset of DD. Patients with at least one co-morbid disorder (N = 46) had an earlier age at onset, presented for the first psychiatric consultation at an earlier age, and were younger at index evaluation for this study with respect to patients without co-morbidity (N = 18). Types of DD differed significantly according to the presence/absence of lifetime co-morbid disorders: DD patients with co-morbidity were in most cases persecutory type (54.4%) while DD patients without co-morbidity were mixed type (66.7%). Our data indicate that there is a considerable proportion of patients whose DDr is strictly connected with other co-occurring psychiatric disorders (mainly affective disorders), which exert an influence on the phenomenology of the illness.
ResumenEl presente estudio investigó la presencia y los correlatos clínicos de la comorbilidad psiquiátrica en una muestra de 64 pacientes con trastorno delirante (TD). Se evaluó a los sujetos con una entrevista semiestructurada para la recogida de rasgos demográficos y clínicos del trastorno; los trastor-nos comórbidos del eje I se determinaron según la entrevista clínica que utiliza el DSM-IV por Othmer y Othmer. Se comparó a los sujetos con trastorno delirante con y sin diagnóstics comórbidos para inves-tigar si la presencia de otro trastorno psiquiátrico influía en los rasgos clínicos de la enfermedad. El 72% de los sujetos tenía un diagnóstic psiquiátrico vital adicional al menos. Se encontró una alta comorbilidad vital con los trastornos afectivos, cuyo comienzo había sido por lo general posterior al comienzo del TD. Los pacientes con un trastorno comórbido al menos (N=46) tenían menor edad en el comienzo, acu-dieron para la primera consulta psiquiátrica a una edad menor y eran más jóvenes en la evaluación índi-ce para este estudio con respecto a los pacientes sin comorbilidad (N=18). Los tipos de TD diferían sig-nificativamente según la presencia/ausencia de trastornos comórbidos vitales: los pacientes con TD con comorbilidad eran de tipo persecutorio (54,5%) en la mayoría de los casos, mientras que los pacientes con TD sin comorbilidad eran de tipo mixto (66,7%). Nuestros datos indican que hay una proporción considerable de pacientes cuyo TD está relacionado estrictamente con otros trastornos psiquiátricos coin-cidentes (sobre todo trastornos afectivos), que influyen en la fenomenología de la enfermedad.
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