Sarah is a 52-year-old female who is referred to psychiatric care by her primary care provider.
Delusional Disorder is a False, Persistent Belief that is held with Absoluteness and Conviction Despite Evidence to the Contrary.
Sarah is a 52-year-old female who is referred to psychiatric care by her primary care provider. Sarah clearly does not feel that the evaluation is necessary and indicates that she has essentially been “blackmailed” by her long-time primary care provider who says he will no longer see Sarah until she has a mental health assessment. The referring PCP reports that Sarah is convinced that she has a cancer that he cannot diagnose. Sarah’s mother, brother, and sister all died from various cancers, and Sarah has become convinced that she has one too, although no one can find it. A genetic evaluation indicates no genetic or familial risk. Sarah has had a thorough physical examination; been screened for colorectal, breast, and cervical cancer; and has also had CT scans of the head and chest; the last two at her request as her mother and brother had brain and lung cancer, respectively. Sarah has no specific symptoms but is fixed in the belief that she has cancer that no one can find. When considering a diagnosis of delusional disorder, the PMHNP would expect Sarah’s evaluation to reveal: