Gender differences in delusional disorder: Evidence from an outpatient sample.

Our objective was to study gender differences in delusional disorder (DD), by comparing potential risk factors, clinical correlates, illness course characteristics, and functionality. The sample was composed of 86 outpatients with DD (according to the SCID-I for DSM-IV criteria). The following assessment instruments were used service use and demographic questionnaires, Standardized Assessment of Personality (SAP), the Positive and Negative Symptom Scale (PANSS), Montgomery-Asberg Depression Rating Scale (MADRS), Mini-Mental State Examination (MMSE), Mini International Neuropsychiatry Interview (MINI), Sheehan Disability Inventory (SDI), and the Global Assessment of Functioning (GAF) scale. The female-to-male ratio was 1.6:1. Men were more likely to be single, while women were more likely to be widows. Men had a greater frequency of schizoid and schizotypal premorbid personality disorders and of premorbid substance abuse. There were no differences for other risk factors (immigration, deafness, late onset, other personality disorders, and family history). Men were younger at onset and more frequently had acute onset of the disorder. Men had more severe symptoms (higher score on the global or separate PANSS scales). There were no gender differences for the remaining symptomatological variables (types of DD, presence and severity of depression, presence of hallucinations, severity of global cognitive functioning and presence of axis I comorbidity). Global and partial (work, family, and social) functioning was significantly poorer among men. Course type and consumption of resources appeared to be similar. We conclude that men with DD had significantly more severe symptoms and worse functionality. They also had a higher frequency of schizoid and schizotypal premorbid personality disorders and premorbid substance abuse.