Primary and Secondary Prevention in Delusional Disorder

Abstract

Background and objectives: Delusional disorder (DD), once entrenched, responds poorly to currently available treatment. This calls for community and individual preventive measures. Our goal was to conduct a literature review exploring the possibilities of prevention.Methods: This is a narrative review based on the PubMed database from inception until July 2022. Search terms were "delusional disorder" OR "delusional psychosis", AND "prevention," OR "early detection," OR "early treatment." Results:We found very little literature specific to DD, but considerable evidence for primary and secondary preventive strategies in use for delusional psychosis (a psychotic illness with prominent delusions). Community strategies included addressing socioeconomic disadvantage and mental health stigma, improving mental health service accessibility, screening for and treating potential precursors to DD, such as sensory and cognitive deficits, as well as psychiatric. symptoms such as depression, anxiety, sleep disturbance, and substance abuse. Secondary community prevention relied on early detection programs and specialized services for early treatment of DD symptoms and their co-morbidities. Individual forms of secondary prevention were interventions especially geared toward illness denial, treatment nonresponse and antipsychotic (AP) refusal. Effective secondary prevention reduced symptom intensity and diminished the risk for fatal outcomes such as suicide.Conclusions: Based mostly on the evidence from related disorders, preventive and early treatment strategies, when put into

Time for Rational Pharmacotherapy in Delusional Disorder

“…Based on the serotonergic hypothesis and the identification of an affective dimension in previous studies, 12,13 the use of antidepressants to treat DD patients with or without comorbid depression may be effective, and it should be considered as a line of research for future clinical trials. In line with the aforementioned findings, recent works have recommended redefining goals for the treatment of DD according to the presence of other domains or psychopathological symptoms and for the demands of age, reproductive status (in women), and other biological factors (dopaminergic and serotonergic dysfunctions) 14 . Rational pharmacotherapy in DD is focused on these aspects 14 …”

“…Alcohol use disorders should also be identified early when treating patients with DD, especially in patients with jealous types. 14 The impact of immigration and crosscultural factors on treatment results should be considered in DD. 17 A study conducted by Tizón et al 18 in 2 socially differentiated neighborhoods found that the prevalence of DD in the community was higher in at-risk environments than in middle-and workingclass neighborhoods.…”

“…In such cases, collaboration between dermatologists and mental health professionals is crucial because insight is frequently poor. Alcohol use disorders should also be identified early when treating patients with DD, especially in patients with jealous types 14 …”

“…In line with the aforementioned findings, recent works have recommended redefining goals for the treatment of DD according to the presence of other domains or psychopathological symptoms and for the demands of age, reproductive status (in women), and other biological factors (dopaminergic and serotonergic dysfunctions). 14 Rational pharmacotherapy in DD is focused on these aspects. 14 Freudenmann and Lepping 15 investigated the role of antipsychotics in primary and secondary delusional parasitosis.…”

“…14 Rational pharmacotherapy in DD is focused on these aspects. 14 Freudenmann and Lepping 15 investigated the role of antipsychotics in primary and secondary delusional parasitosis. The effects of the second-generation antipsychotics risperidone and olanzapine have been evaluated in primary and secondary delusional parasitosis.…”