Delusional disorder physical examination

Patients with delusional disorder usually appear well groomed and well-dressed without evidence of gross impairment. Mental status examination of patients with delusional disorder is usually remarkable for dysphoria, delusional beliefs, and suicidal or violent thinking.^[1]

• Patients are well groomed and well-dressed without evidence of gross impairment.

• The mental status examination is used to assess the patient’s current mental condition.^[1]
• Speech, eye contact, and psychomotor activity may be affected by the emotional state associated with delusions, but are otherwise normal.
• Mood and affect are consistent with delusional content. Mild dysphoria may be present without regard of type of delusions.
• The mental status examiination is usually normal with exception of the presence of abnormal delusional beliefs.
• Suicidal and violent thinking as well as impulsivity should be carefully assessed.

To obtain more information about the delusions or associated symptoms psychological testing may be recommended by the attending psychiatrist. The Minnesota Multiphasic inventory-2 (MMPI-2) may reveal paranoid or grandiose beliefs or somatic concerns related to physical health. Neuropsychological assessment may help make known evidence of impaired cognitive functioning and may suggest brain irregularity.^[2]

• Memory and cognition are intact.
• Level of consciousness is unimpaired.
• Patients with delusional disorder usually have no abnormalityin orientation unless they have a specific delusion about a person, place, or time.
• Tactile and olfactory hallucinations may be present.^[3]

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