Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Honjo1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan
J Clin Psychiatry. 2015 Jun;76(6):691-5. doi: 10.4088/JCP.14m09018.
Delusional jealousy is a psychotic syndrome characterized by a belief in the infidelity of one's spouse that reaches delusional intensity. Although delusional jealousy has been described in relation to organic psychosis, little is known concerning the actual role of delusional jealousy in dementia. The aim of the present study was to investigate the clinical features of delusional jealousy and possible mechanisms whereby delusional jealousy arises in patients with dementia.
We studied 208 consecutive outpatients with dementia (diagnosis based on DSM-III-R criteria; mean [SD] age of 77.0 [8.0] years; study period: September 2011-August 2012). Delusional jealousy was defined as a false belief derived from a pathological jealousy that makes the patient believe that his or her spouse is unfaithful. The prevalence of delusional jealousy was compared between Alzheimer's disease, dementia with Lewy bodies, and vascular dementia. Patients with and without delusional jealousy were compared in terms of general characteristics. In addition, each patient with delusional jealousy and their primary caregivers were interviewed about the clinical features of the syndrome.
Of the 208 patients with dementia, 18 (8.7%) showed delusional jealousy. The prevalence of delusional jealousy in patients who had dementia with Lewy bodies (26.3%) was significantly higher than that in patients with Alzheimer's disease (5.5%) (P < .01). There were no significant differences between patients with and without delusional jealousy in regard to gender (P = 1.00), age (P = .81), educational attainment (P = .29), presence of other persons living with the couple (P = .22), and Mini-Mental State Examination score (P = .47). On the other hand, delusional jealousy was preceded by the onset of serious physical diseases in nearly half of the patients. Delusional jealousy resolved within 12 months after treatment in 15 of 18 patients (83%).
Although delusional jealousy is a considerable problem in dementia, the prognosis of delusional jealousy in demented patients appears to be relatively benign. In dementia, delusional jealousy may develop more easily in patients who have dementia with Lewy bodies and those with coexisting serious physical disorders.
妄想性嫉妒是一种以坚信配偶不忠为特征的精神病综合征，达到妄想强度。虽然已经描述了妄想性嫉妒与器质性精神病有关，但对于痴呆患者中妄想性嫉妒的实际作用知之甚少。本研究的目的是调查妄想性嫉妒的临床特征，并探讨痴呆患者中妄想性嫉妒产生的可能机制。
我们研究了 208 名连续的痴呆门诊患者（根据 DSM-III-R 标准诊断；平均[标准差]年龄为 77.0[8.0]岁；研究期间：2011 年 9 月至 2012 年 8 月）。妄想性嫉妒被定义为源自病理性嫉妒的错误信念，使患者相信其配偶不忠。比较了阿尔茨海默病、路易体痴呆和血管性痴呆患者中妄想性嫉妒的患病率。比较了有和没有妄想性嫉妒的患者在一般特征方面的差异。此外，对每个有妄想性嫉妒的患者及其主要照顾者进行了访谈，了解该综合征的临床特征。
在 208 名痴呆患者中，有 18 名（8.7%）出现了妄想性嫉妒。路易体痴呆患者中妄想性嫉妒的患病率（26.3%）明显高于阿尔茨海默病患者（5.5%）（P<.01）。有和没有妄想性嫉妒的患者在性别（P=1.00）、年龄（P=0.81）、教育程度（P=0.29）、是否有其他同住的人（P=0.22）和简易精神状态检查评分（P=0.47）方面无显著差异。另一方面，近一半的患者在出现妄想性嫉妒之前先出现严重的身体疾病。18 名患者中有 15 名（83%）在接受治疗后 12 个月内妄想性嫉妒得到缓解。
尽管妄想性嫉妒在痴呆中是一个相当严重的问题，但痴呆患者的妄想性嫉妒的预后似乎相对较好。在痴呆中，痴呆伴路易体和并存严重躯体疾病的患者更容易发生妄想性嫉妒。
