This will be discussed when considering the overall treatment approach to delusional disorder. If successful treatment can be achieved, the couple may require considerable psychotherapy and counselling to re-establish a trusting and fear-free relationship.

Case Study Delusional disorder: jealousy subtype A married man aged 47 was arrested by the police after unprovokedly attacking the minister of his church who had been paying a pastoral visit to him and his wife. It emerged that for the past 18 months he had had the growing suspicion that his wife and the minister were having a sexual affair. Lately he had been following her unseen to choir practices and had started to take days off work to observe his own house for secret visits by the minister. Although nothing untoward occurred his conviction grew and his wife reported increasingly alarming jealous outbursts at home. He apparently attacked the minister on the strength of an innocent remark he misinterpreted. On examination in a forensic psychiatric unit he was quiet, mostly rational, and showed some remorse, but still maintained that his wife was committing adultery. He admitted to heavy alcohol use as a young man but not in recent years. Otherwise his history was unremarkable and he was still holding down a steady job. He appeared to have an encapsulated delusional system with jealous content.

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