Very recently, a comparison study 10 including 146 patients with DD has shown differences between disorders in 40 variables. 8 A general population-based sample study in Finland with 8028 subjects assessed the descriptive and predictive validity of DD and featured this as a disorder with a later age onset, absence of symptoms other than delusions, and a relatively good outcome. ![]() The lack of studies could be due to a low prevalence of the disorder 7 and/or DD clinical particularities, such as the combination of a relatively high functioning level along with a prominent lack of insight, which may have limited achievement of optimal sample sizes. To date, only a few comparative studies have approached the differences between DD and SZ assessing different clinical phenomena simultaneously. 5 In addition, a relative preservation of psychosocial activity and absence of unusual or strange behaviour tends to occur. Currently, DD is well established as a psychosis characterised essentially by the presence of one or more delusions that persist for at least 1 5 or 3 months, 6 in which the presence of bizarre delusions or nonprominent hallucinations consistent with the delusional theme are now within its diagnostic criteria. The 1987 DSM-III-R 3 reintroduced the current concept of DD, which somewhat parallels that of paranoia from Emil Kraepelin, 4 who defined paranoia as a disorder characterised by chronic nonbizarre delusions and no evolution to defective states, unlike dementia praecox (schizophrenia). 2 However, for most of the 20th century, paranoia had been considered as some sort of mild version of SZ. ![]() According to him, ‘paranoia’ was a partial psychosis affecting only intellectual functions, preserving other areas of mental functioning and showing a persistent delusional behaviour. ![]() 1 Later in 1863, Kahlbaum recovered the term paranoia, applying it to a disorder presenting delusions as main symptoms. In 1838, Esquirol made the first comprehensive description of paranoia, labelling it as a partial psychosis. Historically, schizophrenia (SZ) has been a much better profiled category than delusional disorder (DD).
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