Question:
A 30 year old man, since 2 months, suspects that his wife is having an affair with his boss. He thinks his friend abroad is also involved and is providing technology support. He thinks people talk ill about him. His friends tried to convince him but he is not convinced at all. Otherwise he is normal. He does not have any thought disorder or any other inappropriate behaviour. The most likely diagnosis is:
A 30 year old man, since 2 months, suspects that his wife is having an affair with his boss. He thinks his friend abroad is also involved and is providing technology support. He thinks people talk ill about him. His friends tried to convince him but he is not convinced at all. Otherwise he is normal. He does not have any thought disorder or any other inappropriate behaviour. The most likely diagnosis is:
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Fixed non-bizarre delusion, no hallucinations or thought disorder, personality intact.
Updated On: Jun 24, 2026
- Paranoid personality disorder
- Persistent delusional disorder
- Schizophrenia
- Acute and transient psychosis
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The Correct Option is B
Solution and Explanation
Step 1: Pick out the core feature. The man holds fixed false beliefs of infidelity (his wife is having an affair) and persecution (people talk ill of him, a friend abroad helps the plot). These are well systematised delusions held for 2 months.
Step 2: Note what is absent. There is no thought disorder, no hallucinations, no inappropriate behaviour, and the rest of his mental life and personality are normal.
Step 3: Apply the criteria. Persistent (delusional) disorder is defined by one or a set of related, non-bizarre delusions lasting at least 3 months (the ICD threshold), with personality and functioning otherwise preserved and no prominent hallucinations or formal thought disorder. The picture fits this exactly.
Step 4: Rule out the distractors. Schizophrenia would need thought disorder, hallucinations, or odd behaviour, which are absent. Paranoid personality disorder is a lifelong pattern of suspiciousness, not discrete fixed delusions of recent onset. Acute and transient psychosis comes on abruptly and is usually polymorphic and short, not a stable single-themed delusion lasting 2 months.
Step 5: Therefore the best fit is Persistent delusional disorder. (Duration here is just under the formal cut-off, but among the four choices this is clearly the intended and correct diagnosis.)
Answer: Persistent delusional disorder.
Step 2: Note what is absent. There is no thought disorder, no hallucinations, no inappropriate behaviour, and the rest of his mental life and personality are normal.
Step 3: Apply the criteria. Persistent (delusional) disorder is defined by one or a set of related, non-bizarre delusions lasting at least 3 months (the ICD threshold), with personality and functioning otherwise preserved and no prominent hallucinations or formal thought disorder. The picture fits this exactly.
Step 4: Rule out the distractors. Schizophrenia would need thought disorder, hallucinations, or odd behaviour, which are absent. Paranoid personality disorder is a lifelong pattern of suspiciousness, not discrete fixed delusions of recent onset. Acute and transient psychosis comes on abruptly and is usually polymorphic and short, not a stable single-themed delusion lasting 2 months.
Step 5: Therefore the best fit is Persistent delusional disorder. (Duration here is just under the formal cut-off, but among the four choices this is clearly the intended and correct diagnosis.)
Answer: Persistent delusional disorder.
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