[...with psychotic features? An investigation into the delusional nature of convictions in patients with non-psychotic disorders].
BACKGROUND
In certain disorders the boundaries between thoughts, obsessions, overvalued ideas and delusions are not always clearly delineated.


OBJECTIVE
To find out whether delusions can be distinguished from the convictions that often accompany anorexia nervosa, obsessive compulsive disorder (OCD), body dysmorphic disorder (BDD) and hypochondriasis, all of which apparently may involve impaired reality testing.


METHODS
The literature was reviewed with the help of PubMed, using as key words 'delusions' in combination with 'hypochodriasis', 'anorexia nervosa', 'body image', 'obsessive compulsive disorder' or 'body dysmorphic disorder'. We also searched the Tijdschrift voor Psychiatrie and references of the literature we used.


RESULTS
A number of disorders can probably be classified on a spectrum ranging from non-psychotic to psychotic. For instance, OCD, hypochondriasis, BDD and to a lesser degree anorexia nervosa can all be particularized as 'with good insight', 'with poor insight' or 'with psychotic features'.


CONCLUSIONS
Current practice in DSM-IV is to classify OCD, BDD or hypochondriasis and a delusional disorder as separate entities; this way of classifying seems to be an artefact. Our findings indicate that a dimensional system of classifying psychotic systems is preferable to a categorised system.
van der Zwaard
R
R
Meerkanten GGZ, Veldwijk Research Institute, Ermelo. rzwaard@meerkanten.nl
de Leeuw
A S
AS
van Dael
F
F
Knook
L M E
LM
D001828:Body Image; D003702:Delusions / Q000145:classification / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000145:classification / Q000523:psychology*; D006801:Humans; D006998:Hypochondriasis / Q000145:classification / Q000523:psychology*; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology*; D013001:Somatoform Disorders / Q000145:classification / Q000523:psychology*; D013850:Thinking