Clinical Features of Delusional Jealousy in Elderly Patients With Dementia

Abstract

Objective: Delusional jealousy is a psychotic syndrome characterized by a belief in the infidelity of one's spouse that reaches delusional intensity. Although delusional jealousy has been described in relation to organic psychosis, little is known concerning the actual role of delusional jealousy in dementia. The aim of the present study was to investigate the clinical features of delusional jealousy and possible mechanisms whereby delusional jealousy arises in patients with dementia.

Prevalence of the core clinical features and the other neuropsychiatric symptoms in dementia with Lewy bodies

“…A previous study showed that persecutory delusions were observed in 65.5% of advanced DLB patients, 5 suggesting that persecutory delusions increased according to the progression of dementia. But the delusion of infidelity was relatively rare in our sample in contrast to a relatively high rate (26.3%) in the previous study 6 . This difference may be influenced by sampling bias, or some cultural differences between regions in Japan.…”

Delusional jealousy as defense mechanisms against late-life aging losses

“…We as practitioners are limited, and can only be there to support the delusional patient. To reassure him that we accept his feelings and help reduce the anger and frustration with minimal intervention as suggested 11 Our role as therapists is to be with the person's "drama", to listen carefully and respect their anxieties and frustrations. To understand the narrative behind the delusional jealousy and to give some comfort by providing secure base, feelings of empathy and care.…”

“…In dementia, delusional jealousy may develop more easily in patients who have dementia with Lewy bodies and those with coexisting serious physical disorders. 11 Zarit & Zarit 12 call such paranoia, evident in people who have a history of stable marriages and stability at work, encapsulated paranoid delusion. Usually, the reference is to a strongly distorted belief that the content of this paranoia is banal and related to reality.…”

When an elder is the abuser

“…12 Delusional jealousy, a conviction about the infidelity of one's spouse, occurs in 9% of people with dementia and may be associated with aggression. 13 This was the most common delusion in the 19% of older domestic homicide offenders with psychosis in NSW. 14…”