Epidemiology

Cases usually present in medical and surgical practices and much less often in a psychiatric context. We have no idea of the frequency because non-psychiatrists make a variety of diagnoses, often untranslatable in psychiatric terms. However, the somatic subtype of delusional disorder is certainly not uncommon, and this is increasingly being revealed as onsultation-liaison psychiatry develops.

These cases make a strong impression on physicians and surgeons because of their insistence and unreasonable demands. To date, dermatologists have been most aware of the nature of the delusional complaining and, in some cases, have learned to treat the deluded patients satisfactorily with appropriate medication. Infectious and tropical disease specialists also have an awareness, as do gastroenterologists and some dentists, and they are gradually referring more cases for psychiatric help. Plastic and cosmetic surgeons see a considerable number of cases with dysmorphic delusions, but it is still rather uncommon for them to seek psychiatric consultations. Since the patient with delusional disorder generally refuses to visit a psychiatrist willingly, it is often necessary for us to consult on the other specialists' territory in order to offer practical help and to obtain a better idea of the illness's frequency.

From what we know, the somatic subtype affects both sexes approximately equally and the age of onset may be from late adolescence to extreme old age. The illness is more common in the unmarried, the divorced, and the widowed.

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