Rosh Psychiatry Board Practice Exam

What diagnosis is appropriate for a patient who believes a celebrity is in love with him and plans their wedding?

1. Delusional disorder, grandiose type

2. Delusional disorder, jealous type

3. Delusional disorder, erotomanic type

4. Delusional disorder, somatic type

The correct answer is: Delusional disorder, erotomanic type

The diagnosis of erotomanic type delusional disorder is appropriate for a patient who believes that a celebrity is in love with him and is planning their wedding. This subtype of delusional disorder is characterized by the false belief that another person, often someone of higher social status or a public figure, is in love with the individual. In this scenario, the patient exhibits a fixed belief about a romantic involvement with a celebrity, despite a lack of evidence to support this belief. The planning of a wedding signifies the intensity and commitment associated with this delusion. In erotomanic delusions, individuals often interpret benign interactions or signs as evidence of love and affection from the object of their delusion. Other subtypes of delusional disorder do not fit the characteristics described in the scenario. For instance, the grandiose type involves inflated self-esteem or belief in one’s exceptional abilities or importance. The jealous type pertains to unfounded beliefs that a partner is unfaithful, and the somatic type focuses on physical ailments or bodily functions that are not based in reality. Since the hallmark of this patient's belief centers on an imagined romantic relationship with a celebrity, categorizing it as erotomanic type aligns perfectly with the symptoms presented.