González-Rodríguez A, Seeman MV. Differences between delusional disorder and schizophrenia: A mini narrative review. World J Psychiatry 2022; 12(5): 683-692 [PMID: 35663297 DOI: 10.5498/wjp.v12.i5.683]
Corresponding Author of This Article
Mary V Seeman, DSc, MDCM, OC, Professor Emerita, Department of Psychiatry, University of Toronto, #605 260 Heath St. West, Toronto M5P 3L6, Ontario, Canada. mary.seeman@utoronto.ca
Research Domain of This Article
Psychiatry
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. May 19, 2022; 12(5): 683-692 Published online May 19, 2022. doi: 10.5498/wjp.v12.i5.683
Differences between delusional disorder and schizophrenia: A mini narrative review
Alexandre González-Rodríguez, Mary V Seeman
Alexandre González-Rodríguez, Department of Mental Health, Mutua Terrassa University Hospital, University of Barcelona, Barcelona 08280, Spain
Mary V Seeman, Department of Psychiatry, University of Toronto, Toronto M5P 3L6, Ontario, Canada
Author contributions: Gonzàlez-Rodriguez A conceived the idea of writing this review, based on our joint clinical experience treating patients with delusional disorder and schizophrenia; both authors contributed equally to decisions about the method and the content; both authors contributed equally to the literature search, and to decisions about what studies to include; both authors shared in the clinical contributions; there were several drafts; Seeman MV perfected the final version.
Conflict-of-interest statement: Neither author has received fees for serving as a speaker, consultant or advisory board member for any organization related to this review. Neither author has received research funding from any one to conduct this review. Neither author owns stocks or shares in any organization remotely connected with this review. Neither author owns patents related to this review. Neither author reports any conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mary V Seeman, DSc, MDCM, OC, Professor Emerita, Department of Psychiatry, University of Toronto, #605 260 Heath St. West, Toronto M5P 3L6, Ontario, Canada. mary.seeman@utoronto.ca
Received: December 18, 2021 Peer-review started: December 18, 2021 First decision: March 13, 2022 Revised: March 23, 2022 Accepted: April 21, 2022 Article in press: April 21, 2022 Published online: May 19, 2022 Processing time: 150 Days and 12.1 Hours
Abstract
Psychotic syndromes are divided into affective and non-affective forms. Even among the non-affective forms, substantial differences exist. The aim of this relatively brief review is to synthesize what is known about the differences between two non-affective psychoses, schizophrenia and delusional disorder (DD), with respect to clinical, epidemiological, sociodemographic, and treatment response characteristics. A PubMed literature search revealed the following: in schizophrenia, hallucinations, negative symptoms and cognitive symptoms are prominent. They are rare in DD. Compared to schizophrenia patients, individuals with DD maintain relatively good function, and their delusions are believable; many are beliefs that are widely held in the general population. Treatments are generally similar in these two forms of psychosis, with the exception that antidepressants are used more frequently in DD and, for acute treatment, effective antipsychotic doses are lower in DD than in schizophrenia. It is with the hope that the contrasts between these two conditions will aid in the provision of safe and effective treatment for both that this review has been conducted.
Core Tip: Although patients with delusional disorder and schizophrenia share clinical similarities, epidemiological and treatment outcomes suggest that these two conditions belong to different diagnostic categories. The onset of delusional disorder (DD) occurs at a relatively late age and, in contrast to schizophrenia, everyday functioning is preserved. Treatment is similar, with more frequent use of antidepressants in DD. Effective targeting of symptomatic domains is important in both these forms of psychosis.
