Citation

González-Rodríguez A, Seeman MV. Psychiatr. Q. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s11126-020-09802-w

PMID

32761556

Abstract

Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to treat with antidepressants, cognitive therapy, or antipsychotic medication. DD is associated with psychiatric comorbidity, especially depression, and rates of suicidal behavior are high when the two conditions co-exist. In this selective review, we present two instances of suicide in the context of DD, one illustrating risks for the somatic subtype and the second, risks for the persecutory subtype. The frequency of suicidal behaviour in these two subtypes of DD is estimated at 8-21%. The literature suggests a prominent role for social emotions (shame, humiliation) in the pathway leading to suicide. In addition, risk factors found in our two patients point to factors such as poverty, living alone, vulnerable risk periods, stigma, and lack of trust in mental health services. Building trust may be the most effective preventive measure.

Language: en

Keywords

Prevention; Suicide; Body dysmorphic disorder; Delusional disorder; Shame