Gender Differences in Persistent Delusional Disorder

Byline: Karishma. Kulkarni, Rashmi. Arasappa, M. Prasad, Amit. Zutshi, Prabhat. Chand, Pratima. Murthy, Kesavan. Muralidharan Sir, Few studies have examined gender differences in persistent delusional disorder (PDD), which itself are under researched. Available literature suggests that PDD is slightly more predominant in females, who tend to have a later age at the onset of illness. Females have also been found to have better treatment response as compared to males, perhaps due to better adherence and treatment-seeking behavior.[sup][1],[2],[3] Some studies have reported erotomanic delusions as being more common in females. Others have reported that persecution is the most common theme of delusions among both males and females, with no gender differences in the content of delusions or comorbid depression.[sup][4] Substance dependence is reportedly more common among males with PDD.[sup][2] We examined gender differences in PDD at a tertiary care center in India. Ethical clearance for the study was obtained from the Institute Ethics Committee. We reviewed the case records of 455 patients with PDD (males: n = 236 [51.9%]; females: n = 219 [48.1%]) as part of a retrospective review published earlier.[sup][5] We examined gender differences on age, sociodemographics, illness variables including age at the onset of illness, duration of illness, family history, clinical and treatment details, occupational functioning, number of follow-ups, and hospitalizations. For between-group comparisons, independent samples t -test was used for continuous variables and Chi-square test for categorical variables. The two groups were comparable on age (females: 40.2 [+ or -] 11.2 years vs. males: 38.7 [+ or -] 11.3 years; t = 1.3, P = 0.7). There were no gender differences on sociodemographic variables, including marital status, the mean age at onset, and the mean duration of illness (all P > 0.2). We did not find gender differences in the phenomenology of the primary delusions; the delusion of infidelity ( ? [sup]2 = 0.03; P = 0.8) was the most common in both groups followed by persecution ( ? [sup]2 = 0.5; P = 0.5). Body dysmorphic delusions (females: 4 [1.8%] vs. males: 20 [8.5%]; ? [sup]2 = 9.6, P 0.5). Family history of schizophrenia was significantly more in females (females: 11.4% vs. males: 5.9%; ? [sup]2 = 3.9, P