Paranoid psychosis delusional disorder pptx - د. صفية

Dr. Safeya alchalabi

Paranoid psychosis(delusional disorder)

paranoid

Paranoid symptoms and paranoid schizophrenia

Delusional disorders (paranoid psychoses)

Epidemiology of delusional disorder

Aetiology of delusional disorder

Types of delusional disorder
Type
Synonymous with, or includes
Jealous
Morbid jealousy, pathological jealousy, erotic jealousy, sexual jealousy, Othello syndrome
Erotic
Erotomania, De Clèrambault’s syndrome
Somatic
Monosymptomatic hypochondriacal psychosis, delusional body dysmorphic disorder
Querulous
Persecutory
Shared
Induced delusional disorder, folie à deux, communicated insanity
Other
• Delusional misidentification syndrome, Capgras syndrome, Fregoli delusion, intermetamorphosis, syndrome of subjective doubles

Pathological jealousy
appears to carry the greatest risk of dangerousness.
The essential feature is an abnormal belief that the patient’s partner is being unfaithful.

Pathological jealousy

The condition is termed pathological because the belief, which may be a delusion or an overvalued idea, is held on inadequate grounds and is unaffected by rational argument.

Pathological jealousy

A man who finds his wife in bed with a lover may experience extreme jealousy and may behave in an uncontrolled way, but this should not be called pathological jealousy.
The term should be used only when the jealousy is based on unsound evidence and reasoning.

Pathological jealousy

Pathological jealousy is more common in men,
about two men were affected for every woman.

Clinical features of pathological jealousy

the main feature is an abnormal belief in the partner’s infidelity.
This may be accompanied by other abnormal beliefs—for example, that the partner is plotting against the patient, trying to poison him, taking away his sexual capacities, or infecting him with venereal disease.

Clinical features of pathological jealousy

Typically, the behaviour involves an intensive search for evidence of the partner’s infidelity—for example, by looking through diaries and by examining bed linen and underwear.

Clinical features of pathological jealousy
The patient may follow the partner about, or engage a private detective.

Clinical features of pathological jealousy

The jealous person often cross-questions the partner incessantly. This may lead to violent quarrelling and paroxysms of rage in the patient.

Clinical features of pathological jealousy

An interesting feature is that the jealous person often has no idea who the supposed lover may be, or what kind of person they may be. Moreover, he may avoid taking steps that could produce unequivocal proof one way or the other.

Aetiology of pathological jealousy

paranoid schizophrenia was reported in 17–44% of patients,
depressive disorder in 3– 16%,
neurosis and personality disorder in 38–57%,
alcoholism in 5–7%, and
organic disorders in 6–20%.

Prognosis of pathological jealousy

It probably depends on a number of factors, including
the nature of any underlying psychiatric disorder and
the patient’s premorbid personality.

Prognosis of pathological jealousy
over 50% of them still had persistent or recurrent jealousy.
This confirms a general clinical impression that the prognosis is often poor.

Risk of violence in pathological jealousy

around 25% had threatened to kill or injure their partner,
56% of men and 43% of women had been violent towards or threatened the supposed rival.

Risk of violence in pathological jealousy

There is also a risk of suicide, particularly when an accused partner finally decides to end the relationship.

Assessment of pathological jealousy

The assessment of a patient with pathological jealousy should be particularly thorough, and should always include the partner, who should be interviewed separately whenever possible.

Treatment of pathological jealousy

the mainstay being antipsychotic drugs
Psychotherapy may be attempted in cases where the jealousy appears to arise from personality problems.

Erotomania

Erotic delusions can occur in any psychotic disorder, especially paranoid schizophrenia, but they are the predominant and persistent symptom in a form of delusional disorder called erotomania.

Erotomania
Erotomania is rare and occurs almost entirely in women

Erotomania

The woman, who is usually single, believes that an exalted person is in love with her. The supposed lover is usually inaccessible, as he is already married, or is a famous person.

Erotomania

Other patients turn from a delusion of love to a delusion of persecution, become abusive, and make public complaints about the supposed lover.

Somatic delusional disorder

People with somatic delusional disorder believe that they suffer from a physical illness, deformity, or infestation