The prevalence of delusional disorder in prison

Delusional disorder has important implications for forensic psychiatrists, as delusions are not infrequently related to criminal behavior. Thus, we hypothesized that delusional disorder is over-represented in correctional populations. We conducted a retrospective chart review of the electronic medical records from 2000 to 2012 of New Jersey Department of Corrections inmates who remained incarcerated as of March 2012. Potential cases of delusional disorder were initially identified by using a search for current or past diagnoses of such disorders or other diagnoses that could be misdiagnosed cases. After an initial chart review identified an inmate as having probable delusional disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria, the diagnosis was confirmed by at least one concurring independent review. We estimate a point prevalence of 0.24 percent for delusional disorder in our population, which is eight times higher than that expected in the community.