Delusional disorders: Prevalence in two socially differentiated neighborhoods of Barcelona

Abstract

Objective

To determine and compare the prevalence and other characteristics of delusional disorder (DD) in two adjacent neighborhoods of Barcelona, La Verneda and La Mina, which differ greatly in their socioeconomic level and psychosocial risk factors.

Methods

Cross-sectional study, by neighborhood, of all cases recorded between 1982 and 2000 in the electronic Case Registry of the La Verneda–La Mina Mental Health Unit. This unit of the Primary Health Care system serves 103,615 inhabitants and has high levels of accessibility.

Results

Of 21,536 mental health case records, 209 patients fulfilled the DD definition according to SASPE criteria (DSM-IV-TR), representing a population prevalence of 0.20% and 0.97% of case records. The DD case prevalence was significantly greater in the neighborhood characterized by an overload of psychosocial risk factors, than in the middle- and working-class neighborhood.

Conclusions

(1) The prevalence of DD indicated in the present community study is much higher than the prevalence reported by other, mainly hospital-based, studies. (2) These experiences/disorders are probably more common in areas characterized by the presence of psychosocial and socioeconomic risk factors. (3) People with DD in these at-risk environments have higher fecundity and fertility than the general population of Barcelona and Catalonia.

Key words:

• delusional disorder
• paranoia
• prevalence
• prevention
• socioeconomic status
• psychosocial history
• urbanicity
• social risk factors
• fertility
• epidemiology

Acknowledgements

We thank Eva Cirera and Enriqueta Pujol for their help in the statistical analyses of the data, as well as Josep Ferrando, Belén Parra, Antonia Parés, Marta Gomà, Conxita Pérez, Françesc Pareja, Marta Sorribes, Belén Marzari and Laia Català for their careful collection and review of the data and Elaine Lilly, PhD, for translation and assistance with manuscript preparation.

The study was supported by a grant for the Proyecto SASPE (02E/99) from the Fundació Seny following the external competitive evaluation by the Agency for the Evaluation of Medical Research and Technology of Catalunya.

Financial help with translation and manuscript preparation was provided by the Fundació Jordi Gol i Gurina (Barcelona, Spain).