In schizophrenia, women are prescribed clozapine or long-acting antipsychotics less frequently than men, but these drugs are not often used for DD. Īs to treatment differences, men and women respond differently to antipsychotic medications both in terms of efficacy and in their susceptibility to adverse effects, but the evidence mostly comes from schizophrenia studies. DD, in which social and personal functioning is superior to that in schizophrenia, starts later in life, which may attenuate gender difference. In schizophrenia, it has also been shown that young women respond more completely to antipsychotic medication than do men, but that this wanes after menopause. Gender differences in DD have thus far been poorly studied, in marked contrast to illnesses such as schizophrenia, where symptoms in young adult women emerge later than they do in men, with a second peak of incidence at the end of the reproductive years. Subtypes of DD have been categorized according to the content of the primary delusion: persecutory, jealous, erotomanic, somatic, grandiose, mixed and unspecified. The prevalence of DD is estimated to be approximately 0.2%. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines delusional disorder (DD) as the presence of one or more delusions, lasting for at least one month or longer, in the absence of affective symptoms, prominent hallucinations or other symptoms of schizophrenia. More rigorous clinical trials need to be conducted.

These recommendations have only been validated in individual patients and families. What is recommended in the literature is to empathically elicit the details of the content of delusions, to address the accompanying emotions rather than the logic of the presented argument, to teach self-soothing techniques, and to monitor behavior with respect to its safety.

Findings are that there is no evidence for differentiated psychosocial treatment for men and women with delusional disorder. This review explores three areas: (a) specific treatments for men and women (b) recommended psychological approaches by health professionals, especially in early encounters with patients with DD and (c) recommended psychoeducation for families. Because the content of men’s and women’s delusions sometimes differ, it has been suggested that optimal interventions for the two sexes may also differ. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for these conditions and to see whether similar strategies can be modeled or taught to family members so that tensions at home are reduced. They are also difficult for family members to bear. Delusional disorders (DD) are difficult conditions for health professionals to treat successfully.

The Grand Delusion by Heath Sommer