Pharmacotherapy for primary delusional jealousy, a retrospective observational study of 32 cases with Othello syndrome
Journal
International Clinical Psychopharmacology
Journal Volume
33
Journal Issue
2
Pages
92-97
Date Issued
2018
Author(s)
Abstract
To determine whether primary delusional jealousy can be treated effectively with antipsychotics or antidepressants, and whether any clinical variables are associated with response to pharmacotherapy, we carried out a retrospective case series observational study by reviewing clinical records of patients with an International Classification of Disease, 9th ed., diagnostic code of 297 (delusional disorders) who were treated at the Department of Psychiatry of a university affiliated hospital from January 2010 to December 2015. Only those records showing obvious delusional jealousy not secondary to other medical conditions, dementia, or schizophrenia were scrutinized thoroughly with respect to types of pharmacotherapy, treatment response, and other demographic and clinical variables likely to be associated with clinical outcomes. All except one of 32 patients, 16 men and 16 women, between 37 and 79 (60.9±10.6) years of age, were treated with low-dose antipsychotics. The general response was favorable as 19 (59.4%) were rated as good and 13 as inadequate responders (seven partial and six limited). Compared with antipsychotic monotherapy, concomitant therapy with antidepressants had a higher rate of good response, although statistically insignificant (75 vs. 53%, P=0.21). Younger age (P=0.01) and presentation at the index visit with their suspected unfaithful spouse were associated with a good response (P=0.036); comorbidity with delusions other than the jealous type was associated with a poor response (P=0.006). The overall outcome for delusional jealousy looks promising if the patients can accept pharmacotherapy in an outpatient setting. Copyright ? 2018 The Author(s). Published by Wolters Kluwer Health, Inc.
Other Subjects
amfebutamone; antidepressant agent; benzodiazepine derivative; escitalopram; hypnotic agent; neuroleptic agent; quetiapine; sertraline; sulpiride; venlafaxine; antidepressant agent; neuroleptic agent; quetiapine; sulpiride; adult; age; aged; Article; case study; clinical article; clinical outcome; female; human; jealous delusion; low drug dose; male; medical record review; middle aged; monotherapy; observational study; outcome assessment; priority journal; psychopharmacotherapy; retrospective study; treatment response; unspecified side effect; classification; combination drug therapy; delusion; dose response; drug monitoring; International Classification of Diseases; jealousy; paranoid schizophrenia; procedures; psychological rating scale; psychology; Taiwan; treatment outcome; Aged; Antidepressive Agents; Antipsychotic Agents; Delusions; Dose-Response Relationship, Drug; Drug Monitoring; Drug Therapy, Combination; Female; Humans; International Classification of Diseases; Jealousy; Male; Middle Aged; Psychiatric Status Rating Scales; Quetiapine Fumarate; Schizophrenia, Paranoid; Sulpiride; Taiwan; Treatment Outcome
Type
journal article