Delusional disorder physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

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.

Physical Examination

Appearance of the Patient

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

Mental status examination

• The mental status examination is used to assess the patient's current mental condition.
• 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.

Neuromuscular

• 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.