Differences between delusional disorder and schizophrenia: A mini narrative review

Table 1 Subtypes of delusional disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition[1]

Subtypes of delusional content
Persecutory type	A preoccupation with the belief that one is being persecuted or conspired against
Somatic type	A conviction that one’s body is defective or infested or malformed
Jealous type	A conviction that one’s lover is unfaithful
Grandiose type	A belief that one is somehow superior to others
Erotomanic type	A false belief that one has aroused the passionate love of someone important
Mixed type	False beliefs that combine the above themes
Unspecified type	A vagueness in the expression of one’s beliefs that does not permit sub-classification

Table 2 Initial approach to patients with delusional disorder

Issue	Target	Recommendation
Safety	For patient, imagined persecutor, and personnel	Safety is the first step
Therapeutic alliance	Patient-clinician relationship is crucial (determines adherence to follow-up)	Building trust for working together on common goals
Enhancing self-esteem and improving skills	Supporting self-esteem and modeling cognitive and social skills	Improving metacognitive and social skills
Targeting emotions and behaviors	Helping patients to identify emotions and prevent acting on delusions	Cognitive-behavioral therapies identify stressors and risk behaviors

Table 3 Main interventions for the treatment of delusional disorder and schizophrenia

Interventions	Explanation	Remarks
Antipsychotics[57-60]	Antidopaminergic action of these drugs dominates the literature	Genetic studies are inconclusive about the role of dopamine
Antidepressants[62]	Antidepressants treat comorbid depression	Reversing depression can sometimes eliminate delusions
Cognitive behavioral therapy[63-65]	Addresses cognitive biases and unwanted behavior	Stops adverse behaviors and improves adherence to treatment