OBJECTIVES: We set up a case register of all delusional disorders diagnosed among all patients attending the mental health public health service provided by Sant Joan de Déu-SSM (SJD) in Barcelona (Spain). The catchment area for the cases register is an area with a total of 700.000 inhabitants. Cases of Delusional disorder (DD) included in the register are all those having obtained such diagnoses by a trained psychiatrist using clinical DSM-IV criteria. Thus, out of 77000 cases transferred to our community services in the above-named area, 440 have had a diagnosis of DD over the 5 year period during which our register has been on. The objectives of this preliminary phase of the study are the quantification and identification of cases and subtypes, the study of comorbidity with other disorders of Axis I and personality disorders (Axis II), as well as the assessment of functioning (Axis V) and the use of sanitary resources. Finally, we compared such variables between elderly and younger adults.
MATERIAL AND METHODS: 440 patients (n=440) with clinically established DSM-IV diagnosis of delusional disorder were included in the study. We collected information for a variety of independent variables including socio-economic status, marital status, DSM-IV multiaxial diagnosis, number of out-patient, emergency and hospital consultations (over 2001 and 2002) and functioning GAF level. The two dependent variables assessed are, respectively, delusional disorder subtypes (comparison between them) and elderly vs. young adult. The statistic analysis was made using SPSS 10.0 package, utilizing continuous variables standardisation, ANOVA comparisons among subtypes analysis and Student T for the elderly vs. youg analysis. The dichotomous variables has been studied in both analysis with contingence tables applied to both independent variables, using non parametric univariate tests.
RESULTS: 256 patients are women and 184 are men. The average age of the sample is 54,6 years; 122 patients are elderly (older than 65 years). The table I shows the results of subtypes analysis, finding out significant differences in the following variables: GAF functioning (worse functioning in somatic subtype) and number of emergency consultation (more frequent in persecutory type and less frequent in jealous type). Significant differences have been found in the comorbidity with other disorders of Axis I but not with those of Axis II. With regard to the analysis comparing the elder subgroup with the younger, we found comorbidity differences with Axis II (more frequent the persecutory subtype, no case of schizoid or schizotypal personality disorders (p=0.001) and use of health resources (fewer consultations to emergency and out patient service among the elderly group, but a similar number of hospital attendance).
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