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Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review

Background: Compared to other psychotic disorders, there is little information about staging care in delusional disorder (DD). Unlike schizophrenia, this is a disorder that begins in middle age, a time at which chronic medical comorbidities have already begun to impact global functioning. With age,...

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Autores principales: González-Rodríguez, Alexandre, Seeman, Mary V., Román, Eloïsa, Natividad, Mentxu, Pagés, Carmen, Ghigliazza, Camila, Ros, Laura, Monreal, José A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9956049/
https://www.ncbi.nlm.nih.gov/pubmed/36832992
http://dx.doi.org/10.3390/healthcare11040458
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author González-Rodríguez, Alexandre
Seeman, Mary V.
Román, Eloïsa
Natividad, Mentxu
Pagés, Carmen
Ghigliazza, Camila
Ros, Laura
Monreal, José A.
author_facet González-Rodríguez, Alexandre
Seeman, Mary V.
Román, Eloïsa
Natividad, Mentxu
Pagés, Carmen
Ghigliazza, Camila
Ros, Laura
Monreal, José A.
author_sort González-Rodríguez, Alexandre
collection PubMed
description Background: Compared to other psychotic disorders, there is little information about staging care in delusional disorder (DD). Unlike schizophrenia, this is a disorder that begins in middle age, a time at which chronic medical comorbidities have already begun to impact global functioning. With age, the combination of psychological and somatic conditions leads to new behaviours, e.g., agitation, aggression, and behaviours that require specific preventive and interventive measures. With further age, knowledgeable end-of-life care becomes necessary for this population. Aim: The aim of this article was to review existing evidence on the management of these successive phases. Methods: We conducted a narrative review using PubMed and ClinicalTrials.gov and searched for the following terms: (agitation OR aggressivity OR aggression OR palliative OR “end-of-life”) AND (“delusional disorder”). Results: We found that the literature was sparse. Existing evidence suggests that medical causes are frequently at the root of agitation and aggression. With respect to management, de-escalation strategies are generally preferred over pharmacotherapy. Specific delusional syndromes, e.g., de Clérambault, Othello, Capgras, Fregoli, as well as folie à deux, are associated with aggression. The somatic subtype of DD is the one most often requiring palliative care at the end of life. Conclusions: We conclude that insufficient attention has been given to the care needs of the accelerated aging process in DD.
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spelling pubmed-99560492023-02-25 Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review González-Rodríguez, Alexandre Seeman, Mary V. Román, Eloïsa Natividad, Mentxu Pagés, Carmen Ghigliazza, Camila Ros, Laura Monreal, José A. Healthcare (Basel) Review Background: Compared to other psychotic disorders, there is little information about staging care in delusional disorder (DD). Unlike schizophrenia, this is a disorder that begins in middle age, a time at which chronic medical comorbidities have already begun to impact global functioning. With age, the combination of psychological and somatic conditions leads to new behaviours, e.g., agitation, aggression, and behaviours that require specific preventive and interventive measures. With further age, knowledgeable end-of-life care becomes necessary for this population. Aim: The aim of this article was to review existing evidence on the management of these successive phases. Methods: We conducted a narrative review using PubMed and ClinicalTrials.gov and searched for the following terms: (agitation OR aggressivity OR aggression OR palliative OR “end-of-life”) AND (“delusional disorder”). Results: We found that the literature was sparse. Existing evidence suggests that medical causes are frequently at the root of agitation and aggression. With respect to management, de-escalation strategies are generally preferred over pharmacotherapy. Specific delusional syndromes, e.g., de Clérambault, Othello, Capgras, Fregoli, as well as folie à deux, are associated with aggression. The somatic subtype of DD is the one most often requiring palliative care at the end of life. Conclusions: We conclude that insufficient attention has been given to the care needs of the accelerated aging process in DD. MDPI 2023-02-05 /pmc/articles/PMC9956049/ /pubmed/36832992 http://dx.doi.org/10.3390/healthcare11040458 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
González-Rodríguez, Alexandre
Seeman, Mary V.
Román, Eloïsa
Natividad, Mentxu
Pagés, Carmen
Ghigliazza, Camila
Ros, Laura
Monreal, José A.
Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title_full Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title_fullStr Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title_full_unstemmed Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title_short Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
title_sort critical issues in the management of agitation, aggression, and end-of-life in delusional disorder: a mini-review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9956049/
https://www.ncbi.nlm.nih.gov/pubmed/36832992
http://dx.doi.org/10.3390/healthcare11040458
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