From the Research
The prognosis of erotomanic delusional disorder is generally poor without treatment, with most cases following a chronic course, but treatment outcomes can improve significantly with early intervention, consistent treatment adherence, and absence of comorbid conditions, as suggested by the most recent study 1. The disorder, characterized by the false belief that another person (often of higher status) is in love with the affected individual, typically persists for years or even decades. Key factors influencing treatment outcomes include:
- Duration of symptoms before intervention
- Patient's insight into their condition
- Willingness to engage in treatment Antipsychotic medications such as risperidone (2-6 mg daily), olanzapine (5-20 mg daily), or pimozide (1-4 mg daily) are the primary pharmacological treatments, typically requiring long-term administration of at least 6-12 months after symptom resolution, as supported by studies 2, 3, 4. Psychotherapy, particularly cognitive behavioral therapy focusing on challenging delusional beliefs, serves as an important adjunct to medication, with recommendations for staged interventions, including establishing a therapeutic alliance, providing social support, and correcting cognitive biases, as outlined in 5. However, even with optimal treatment, many patients experience periodic relapses or persistent attenuated symptoms, necessitating ongoing monitoring and sometimes lifelong maintenance therapy. The disorder's impact on social and occupational functioning can be profound, with many patients experiencing relationship difficulties, legal problems from stalking behaviors, and social isolation. Overall, a comprehensive treatment approach, combining medication and psychotherapy, is essential for managing erotomanic delusional disorder and improving patient outcomes, as emphasized by the most recent and highest quality study 1.