Recent evidence supports an association between oestrogen levels and severity of psychopathology in women with schizophrenia. However, few studies have investigated differences in the psychopathology of premenopausal and postmenopausal female delusional disorder (DD).

To investigate whether men, premenopausal and postmenopausal women differ in age at onset and psychopathology.

Psychopathological symptoms were assessed in 64 outpatients with DD (DSM-IV-TR), as part of the Study on the Development and Course of Delusional Disorder in mean-age and the Elderly (DEVCODEL Study), at baseline and after 6 months. Scores in the PANSS scale, PSP for functionality, HRSD-17 items, C-SSRS for suicide and the first three items of the SUMD Scale were outcome variables. ANOVA and Chi-square tests were performed. Psychopathological differences between groups were investigated by applying Analysis of Covariance.

68.8% of the sample were postmenopausal women. When compared to premenopausal women and men, postmenopausal women had a lateonset disease (p<0.001) and attended later our outpatient clinic (p<0.001). Furthermore, postmenopausal women showed lower scores in awareness of mental disorder and awareness of the achieved effects of medication, a tendency of higher scores in depressive symptoms and higher severity of suicidal ideation at baseline. After 6 months, men and premenopausal women had lower scores in the positive PANSS subscale (p=0.041) than postmenopausal women. These findings in psychopathology held significant after adjustment for age and accumulated years of disease.

Our results support the notion that postmenopausal DD women have higher severity in psychopathology in comparison with premenopausal women and men.