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New Study Identifies Four Subtypes of Delusional Conditions


Delusional problems (DD) are a controversial condition that has been hotly debated in psychological arenas. There are many degrees of DD and it is often considered to be closely related to the schizo or affective spectrums. Visual and auditory hallucinations do not always occur in DD, yet delusions of paranoia can exist.

To get a better idea of the types of DD and what symptoms are associated with each category, Enrique de Portugal of the Department of Psychiatry at Unversidad Complutense de Madrid in Spain recently conducted a study involving 86 participants with DD. He assessed family history, cognitive functioning, hallucinations, mood, and other symptoms to determine what degrees and classifications of DD were most common.

De Portugal discovered four specific categories of DD including cognitive, paranoid, affective and schizoid. The cognitive category was evidenced by somatic symptoms, visual hallucinations, low cognitive functioning, and history of substance misuse. People in this category had very few affective symptoms.

The paranoid category included participants with personality disorders, childhood adversity, legal issues, poor treatment response, and a more chronic history of DD. Participants in the affective category had a higher chance of family history of affective issues, specifically depression. They were more likely to have somatic delusions and tactile hallucinations than any other group. These participants also had higher rates of obsessive behaviors, stress, anxiety, and suicidal ideation.

The final category was the schizoid category. These participants were more likely to have a family history of psychosis or schizophrenia, auditory hallucinations and high rates of dysthymia. They were also more likely to be single than participants from the other groups.

De Portugal reported that gender did not play a significant role in risk except with respect to the affective category, which was represented by women more than men. This could be due to the fact that women are at higher risk than men for depression and other affective conditions. De Portugal concluded by saying, “The identification and clinical validation of four separate psychopathological dimensions in DD provide evidence toward a more accurate conceptualization of DD and its types.”

De Portugal, Enrique, et al. (2013). Empirical redefinition of delusional disorder and its phenomenology: The DELIREMP Study. Comprehensive Psychiatry 54.3 (2013): 243. ProQuest. Web.

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  • Monica June 8th, 2013 at 6:00 AM #1

    I know that this could be helpful for providers but to the average person, delusional is still just gonna look delusional and there will be no differentiation.

  • Tyler June 9th, 2013 at 9:18 PM #2

    Delusional issues must be so hard on the psyche…I think although the effects do not get any better through categorization, it would definitely help in proper and better treatment…And that should be the goal after all – reduction of symptoms and managing the condition.

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