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Persistent delusional disorder

The variations in human personality are astonishing. It is thanks to this branch that I am privy to a huge spectrum of behaviors and personalities of people. Among the patients that I saw today was this individual whose wife suspects him to be having an extra-marital affair. Now what should have gone to a marriage counselor or a lawyer had come to me because the 'doubt' that the lady had was held with extraordinary conviction but apparently without any real evidence or trigger. In such cases the first question as a Psychiatrist is that am I dealing with a delusion or the lady has a genuine reason to suspect her husband of infidelity. Well, there are definite pointers that the lady has delusion of infidelity for example that the hapless husband hasn't displayed any such proclivities has been attested to by the relatives of the gentleman. Moreover the doubt pattern has a certain obsessive character as usually a female suspecting her husband of something such will not ma...

Introduction

Before I did my MD in Psychiatry I had worked as a general physician for around 13 years. As a general physician I saw patients with complaints ranging from acute problems like enteric fever to chronic ones like diabetes mellitus. There was one thing that I noticed that of the 60 odd patients coming to my opd on an average at least 35-40 were coming with vague complains like some chronic pain that would shift its site, or dyspepsia, non specific weakness, fatigue. The sex ratio was heavily tilted with a female preponderance. As a young physician I would often rack my brain to go to the physiological or medical reason behind these complains. At times the people would respond to the treatment given only to have a fresh set of vague complains a few days later. I had the luxury of following up this group of patients for 13 years and a majority never really found any organic basis for these complaints and almost 50 percent of them indulged in extensive 'doctor shopping', tried di...