DELUSIONAL DISORDER Paranoia and Related Illnesses

Delusional disorder, once termed paranoia, was an important diagnosis in the late nineteenth and early twentieth centuries. Subsequently it was subsumed with schizophrenia, and only in 1987 was it reintroduced into modern psychiatric diagnosis. This book aims to reconcile recent knowledge with older ideas about the condition, and thereby to provide a contemporary perspective to the concept of delusional disorder and to integrate the scattered literature on the topic. The illness has a characteristic form, but the content of the delusional system can vary widely. Sufferers may deny mental illness and refuse psychiatric help, so that mental health professionals, who should be at the forefront in dealing with delusional disorder, are often the last to see it. Psychiatrists and other clinicians will therefore appreciate this review of a disorder once considered untreatable but in fact, as the author shows, responsive to appropriate management. The text deals with the emergence of the concept of delusional disorder, and goes on to detail its manifold presentations, differential diagnosis and treatment. Many instructive case histories are provided, illustrating manifestations of delusional disorder including the persecutory and somatic subtypes, and variants including dysmorphic and infestation delusion, erotomania, and related conditions in the paranoid spectrum such as paraphrenia, folie à deux and paranoid personality disorder. This is the most wide ranging and authoritative text on the subject to have appeared for many years, and the first to suggest, based on the author’s extensive experience, that the category of delusional disorder should contain not one but several conditions. It also emphasizes that, contrary to traditional belief, delusional disorder is a treatable illness.