Occurrence and clinical correlates of psychiatric co-morbidity in delusional disorder

Abstract

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.

Delusional disorder: no gender differences in age at onset, suicidal ideation, or suicidal behavior

“…These results are consistent with previous studies carried out in the last decades 7,8 and those performed in patients with schizophrenia. 27,28 In agreement with the Halle Delusional Syndromes Study (HADES-Study), 11,12 we found no gender differences in the presence of depressive symptoms, depressive episodes, suicidal ideation, or suicide attempts during follow-up.…”

“…Maina et al found depressive comorbidity as an explanatory finding of an earlier age at onset of DD. 7 In previous studies, age at onset differed significantly according to the delusional theme. 9 For this reason, in the present study we included the presence of depressive comorbidity, DD type, and other psychosocial factors as covariates in the ANCOVA models.…”

“…These findings are in agreement with data from other authors who found that patients with DD and psychiatric comorbidity had an earlier age at onset and presented for a first appointment at an earlier age. 7 Despite these differences, in the study mentioned above, types of DD were reported to differ according to the presence or absence of lifetime comorbid disorders. By contrast, in a cross-sectional study of 86 outpatients with DD, de Portugal et al 8 found no differences regarding age at onset, age at first psychiatric consultation, or functionality outcomes between patients with and without comorbid disorders.…”

“…4,5 Gender investigations focusing on age at onset and clinical features have also been conducted in delusional disorder (DD). [6][7][8][9] However, other demographic and clinical factors have also been reported in association with earlier onset in male DD patients than in women. A recent study on psychiatric comorbidity in DD showed that 64.8% of the subjects suffered from a comorbid disorder, with depressive disorders being the most common.…”

Diferencias de género en el trastorno delirante

“…Otros estudios han observado esta mayor proporción del TD en mujeres (3,5,(7)(8)(9)(10). Sin embargo, dicho hallazgo no es consistente con DSM-IV, ni con el estudio publicado recientemente por Wustmann y cols.…”