A 35-year-old woman with no prior psychiatric history presents believing that her neighbor, a famous celebrity, is secretly in love with her and sends her coded messages through television broadcasts. She has no hallucinations, her behavior is not disorganized, and her affect is appropriate. She holds a steady job and maintains social relationships. She has held this belief firmly for 5 months despite clear evidence to the contrary. What is the most likely diagnosis?

• A Schizophrenia, paranoid type
• B Brief psychotic disorder
• C Shared delusional disorder
• D Delusional disorder, erotomanic type ✓

Explanation

Delusional disorder is characterized by one or more non-bizarre delusions lasting at least 1 month without the other hallmark symptoms of schizophrenia (prominent hallucinations, disorganized speech, or grossly disorganized behavior) and with relatively preserved functioning. The erotomanic subtype involves the belief that another person — often of higher social status — is in love with the individual. Schizophrenia requires additional psychotic symptoms and broader functional decline.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.