An Overview of Treatment in Paranoia / Delusional Disorder

Abstract

Objective To examine delusional disorder (formerly paranoia) which has re-emerged as an important diagnosis in psychiatry and familiarize present-generation psychiatrists with this disorder and its treatment. To benefit other researchers, a bibliography is appended. Method Approximately 1,000 articles on paranoia/delusional disorder were analyzed in detail. These articles date from 1961 with the greater majority dating from 1980 onward. Case descriptions were often vague and only cases identifiable by DSM-IV diagnostic criteria were accepted. Eventually 257 cases were accumulated, but it was only possible to report on treatment aspects of 209 of these, due to lack of detail. Results Because the data are so disparate, and the literature is confusing in therapeutics aspects, only the broadest conclusions can be drawn. However, it does appear that when adequately treated, delusional disorder is an illness with a reasonably good prognosis. Cases respond equally well to treatment, whatever the specific delusional content, and pimozide currently appears to be the neuroleptic which produces the best results. Conclusions There is an urgent need to raise standards in the study of delusional disorder and its treatment.