The conceptual revisión of paraphrenia and the defenceof its clinical distinctive features with respect to other psychotic disorders(Schizofrenia or Delusional disorder

A case report: The patient is a 52 years old male who is referred to the Acute Mental Health Unit, by his primary care physician, regarding an infection caused by the Devil, who takes the form of a micro-organism.

The patient shows a long term psychotic psychopathology, based on a chronic delusion of Mystical and Esoteric nature. He describes the origins of the Universe, and explains the formation of different Civilizations throughout History, originated by the interaction of Gravity forces, Alien intelligence and the Elder Gods, in the end creating what he calls ‘The Pangea” All these powers converge in Morocco, leading the patient to believe himself to be the epicenter of the eternal fight between good and evil. He also has coenesthetic hallucinations which are secondary to those delusionas and, therefore, reinforce them.

The patient speaks with an affective indifference towards this matter, and had a superior tone of voice. He shows no awareness of the disease. He has always been socially well-adjusted, with a normal family and workinf life. He shows no processual impairment.

In this clinical case it is difficult to make an accurate diagnosis, according to the current guides for psychotic disorders. Nor does it fit the paranoid Schizophrenic disorder criteria neither the Delusional disorder criteria.

We consider that, in this case, the diagnosis does not suit he criteria for a Paranoid Schizophrenia or a delusional disorder. Even though some guides, such as the CIE 10, include the paraphrenia as part of the Delusional Disorder Spectrum, we believe it should be considered as a distinct disorder with possible intermediate traits from both. While it is true that the new diagnostic guides have given us an advantageous classification of all the mental disorders, we should not dismiss the current uselfulness of the classical studies of psychopathology regarding diagnosis.