A 48-year-old man insists for three years that his wife is having an affair with his colleague, citing trivial evidence such as her coming home ten minutes late. He has hired a detective, checked her phone secretly, and confronted the colleague. Apart from these fixed beliefs, his work and social functioning are intact, and he has no hallucinations. What is the most likely diagnosis?
- A Delusional disorder, jealous type ✓
- B Paranoid schizophrenia
- C Schizotypal personality disorder
- D Obsessive-compulsive disorder
Correct answer: A. Delusional disorder, jealous type
Explanation
Delusional disorder is defined by a non-bizarre, fixed delusion lasting at least one month with otherwise preserved functioning and absence of prominent hallucinations or disorganization, which fits this jealous (Othello) presentation exactly. Paranoid schizophrenia requires additional features such as hallucinations, formal thought disorder, or functional decline over six months. OCD infidelity doubts are recognized as irrational by the patient, whereas this man acts on his belief with total conviction.
Reference: DSM-5-TR, 2022 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.