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

Kuan Pin Su, Chung Yao Hsu, Shu Chiang Hsieh, Winston W. Shen

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)121-126
Number of pages6
JournalPsychiatry and Clinical Neurosciences
Volume55
Issue number2
DOIs
Publication statusPublished - 2001

Fingerprint

Paranoid Schizophrenia
Cerebrovascular Disorders
Delusions
Magnetic Resonance Imaging
Psychiatry
Blood Vessels
Nervous System Diseases
Age of Onset
Neuroimaging
Diagnostic and Statistical Manual of Mental Disorders
Atrial Fibrillation
Electroencephalography
Diabetes Mellitus
Hypertension
Brain

Keywords

  • Magnetic resonance imaging
  • Organic delusional disorder
  • Vascular delusion
  • White matter lesions

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease : A report of seven cases. / Su, Kuan Pin; Hsu, Chung Yao; Hsieh, Shu Chiang; Shen, Winston W.

In: Psychiatry and Clinical Neurosciences, Vol. 55, No. 2, 2001, p. 121-126.

Research output: Contribution to journalArticle

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