Paranoid ideas occur very often in humans (prevalence of 0.2%). According to several studies, the origin could be found in a genetic predisposition to a selective hyperdopaminergia related to the D2 receptor and dopamine neurotransmitter dysfunction.

To delve into this pathology, including origin and development, epidemiology, diagnostic criteria, clinical aspects, differential diagnosis, treatment, evolution and prognosis.

We conducted a literature review of delusional disorder.

The disease appears in middle age, between ages 35 and 55, being slightly more frequent in women. It seems to affect more economically and educationally disadvantaged social strata, and it is more frequent in immigrants. The onset is usually progressive and insidious. Correct perception but delusional interpretation: the objectivity of what is perceived is disturbed by the subjectivity of what is registered. The delirium is usually logical, contagious, and frequently credible. Patients retain their lucidity. It is very important to make a correct differential diagnosis with schizophrenia. With regard to treatment, the therapeutic relationship with the patient will be basic. If possible, psychotherapy should be combined with pharmacological treatment (second generation antipsychotics being the treatment of choice). In general, their evolution is compatible with out-of-hospital life, being considered “odd guys”.

The risk of suffering from Delusional Disorder during the lifetime is between 0.05 and 0.1%. This pathology constitutes 1-4% of all psychiatric admissions. Therefore, it is essential to know it in depth in order to be able to manage it properly.

No significant relationships.

Some psychological disorder-comorbid with a medical diagnosis-presents a challenge for treatment because of diagnostic and treatment dilemmas. This study investigated associations between Psychoticism and Paranoid ideas in internal medicine and A&E1patient in a university hospital.

In this cross-sectional study, we checked 150 patients of internal medicine department and 150 patients, who have admitted to the A&E department as a control group. They have chosen by a Purposive accessible sampling method. The psychopathological profile was assessed using the SCL-90 questionnaire by Iranian version. Data have been computed and analyzed by SPSS V.17 and we used t-student, Mann-Whitney tests and logistic regression methods. The results have been considered significant when the two tailed p-value was less than 0.05.

In internal ward 70% and A&E department 43.3% of patient have had Paranoid ideas (OR= 4.2; 95% CI, 1.9 to 8.9). Psychoticism were observed in 38% of internal medicine patients and 20% of A&E's patients (OR= 7.64; 95% CI, 3.2 to 17.8).

The present results confirm the high prevalence rate of Psychoticism and Paranoid ideas in patients that hospitalized in internal to A & E ward. Recommendation are made to further investigate by greater sample size and different setting in this field is warranted.

Frontotemporal dementia (FTD) constitutes a spectrum of neurodegenerative disorders associated with degeneration of, predominantly, the frontal and temporal lobes. The clinical heterogeneity is evident, and early diagnosis is a challenge. The primary objectives were to characterize psychotic symptoms, initial clinical diagnoses and family history in neuropathologically verified FTD-patients and to analyze possible correlations with different neuropathological findings.

The medical records of 97 consecutive patients with a neuropathological diagnosis of frontotemporal lobar degeneration (FTLD) were reevaluated. Psychotic symptoms (hallucinations, delusions, paranoid ideas), initial diagnosis and family history for psychiatric disorders were analyzed.

Psychotic symptoms were present in 31 patients (32%). There were no significant differences in age at onset, disease duration or gender between patients with and without psychotic symptoms. Paranoid ideas were seen in 20.6%, and hallucinations and delusions in 17.5% in equal measure. Apart from a strong correlation between psychotic symptoms and predominantly right-sided brain degeneration, the majority of patients (77.4%) were tau-negative. Only 14.4% of the patients were initially diagnosed as FTD, while other types of dementia were seen in 34%, other psychiatric disorders in 42%, and 9.2% with other cognitive/neurological disorders. The patients who were initially diagnosed with a psychiatric disorder were significantly younger than the patients with other initial clinical diagnoses. A positive heredity for dementia or other psychiatric disorder was seen in 42% and 26% of the patients respectively.

Psychotic symptoms, not covered by current diagnostic criteria, are common and may lead to clinical misdiagnosis in FTD.