Delusional Disorder
One or more delusions lasting ≥1 month without other prominent psychotic features.
Etiology (Biopsychosocial Model)
Biological: Dopaminergic dysregulation; possible shared genetic vulnerability with schizophrenia.
Psychological: Cognitive bias, rigid belief systems.
Social: Isolation, immigration stress, cultural misinterpretations.
Symptoms & Diagnosis (Mnemonic: BELIEVE)
- B - Behavior is not obviously bizarre
- E - Excludes schizophrenia criteria
- L - Lasts ≥1 month
- I - Impact on functioning is limited
- E - Excludes substance/medical cause
- V - Various subtypes (e.g., persecutory, erotomanic, somatic)
- E - Episodes of mood disturbance brief relative to delusional periods
Treatment
Antipsychotics: (e.g., risperidone, olanzapine)
CBT: for cognitive restructuring
Psychoeducation and family involvement
Info
DSM-5-TR Code
F22
Prevalence
~0.2% lifetime prevalence; onset usually in middle to late adulthood.