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Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: a report of seven cases.

Abstract：

:Delusions associated with cerebrovascular diseases have been sporadically reported. Although both psychiatrists and neurologists attempted to link delusions with anatomical locations of the brain lesion, comorbid psychiatric and neurological disorders make the interpretation of delusions difficult. The purpose of the present paper is to report the clinical features and magnetic resonance imaging (MRI) characteristics in patients with delusional disorder due to diffuse cerebrovascular diseases, and to redefine the concept of 'vascular delusion'. The clinical features and MRI findings were reviewed retrospectively in a series of seven patients with 'delusional disorder due to cerebrovascular disease' as defined in Diagnostic and Statistical Manual of Mental Disorders (DSMIV). The average age of onset is 64. No patient had a prior personal or family history of major psychiatric illness. The illness is presented as acute, subacute or stepwise course. Hypertension was present in all patients. Two had diabetes mellitus, and one had atrial fibrillation. Three had clinical evidence of previous cerebrovascular attacks, only one showed minor neurological deficits. Three had diffuse cortical slow wave in electroencephalogram. No patient had significant cognitive impairment but had multiple cortical and subcortical cerebrovascular lesions in MRI, with white-matter lesions (WML) in bilateral frontal areas. Delusional disorder due to diffuse cerebrovascular change is characterized by late-onset, stepwise course, and comorbid medical and neurological diseases. The results of vascular changes in the present study did not establish a cause-effect relationship and should be considered as multifactorial in pathogenesis. The findings suggested the hypothesis of neural circuit theory. Further studies in larger numbers of patients and newer neuroimaging techniques are needed to expand the knowledge learned from these findings.

journal_name

Psychiatry Clin Neurosci

journal_title

Psychiatry and clinical neurosciences

authors

Su KP,Hsu CY,Hsieh SC,Shen WW

doi

10.1046/j.1440-1819.2001.00798.x

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

121-6

issue

eissn

1323-1316

issn

1440-1819

pii

pcn798

journal_volume

pub_type

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Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: a report of seven cases.