title: Clinical Presentation and Course of Persistent Delusional Disorder: Data From a Tertiary Care Center in India.
abstract: OBJECTIVE
  Despite its long history as a psychiatric diagnosis, little is known about the sociodemographic and clinical profile of persistent delusional disorder (PDD) or its subtypes, treatment response, and outcomes, particularly in India. We examined the clinical characteristics and course of PDD in patients presenting to a tertiary neuropsychiatry center in India.
  
  
  METHODS
  A retrospective chart review of patients diagnosed with PDD (ICD-10) between January 2000 and May 2014 was conducted. Sociodemographic and clinical data including age at onset, total duration of the illness, clinical symptoms and treatment, hospitalizations, occupational functioning, and follow-up were extracted from the files. The study was approved by the institute ethics committee.
  
  
  RESULTS
  The sample (N = 455) consisted of 236 men and 219 women. The mean age at onset was 32.36 ± 10.47 years. The most common delusion was infidelity (n = 203, 44.6%) followed by persecution (n = 149, 32.7%). Hallucinations were present in 78 (17.1%), depressive symptoms in 187 (41.1%), and comorbid substance dependence in 61 (13.4%) subjects; 141 subjects (31.0%) had a family history of mental illness. Follow-up data were available for 308 subjects, of whom 285 (92.5%) reported good compliance with medication. Of the subjects, 163 (52.9%) showed a good response to treatment. The diagnosis of PDD remained unchanged in 274 of 308 subjects (88.9%).
  
  
  CONCLUSIONS
  In our center, PDD appears to be uncommon and has a near-equal gender representation. Infidelity was the most common delusion, which is in contrast to the reported literature. The diagnosis of PDD appears to be stable with good response to atypical antipsychotics if compliance can be ensured.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Karishma R
authors.initials: KR
authors.lastname: Kulkarni
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Arasappa
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Krishna M
authors.initials: KM
authors.lastname: Prasad
authors.affiliation: Epworth Hospital, Camberwell, Victoria 3124, Australia.
authors.forename: Amit
authors.initials: A
authors.lastname: Zutshi
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Prabhat K
authors.initials: PK
authors.lastname: Chand
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Kesavan
authors.initials: K
authors.lastname: Muralidharan
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.
authors.forename: Pratima
authors.initials: P
authors.lastname: Murthy
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005114:Extramarital Relations; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012563:Schizophrenia, Paranoid / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents