When paranoia and the other paranoid spectrum disorders were widely-accepted diagnostic entities, there was no effective treatment for any psychiatric illness. There were many ‘therapies’ but, unless the illness was self-limiting, few if any therapeutic successes.

While paranoia was in abeyance for many years as a recognized illness, useful treatments began to appear in psychiatry and many illnesses which were previously regarded as hopeless are now readily treatable. Unhappily, when DSMIIIRs description of delusional disorder revived our awareness of paranoia, it somehow failed to dispel the nihilistic view of treatment which had been justified 50 years before.

Nowadays, delusional disorder is treatable, often highly treatable, but it has to be recognized that the patient has to be persuaded to comply with treatment, and the treatment must be appropriate. The burden of Chapter 13 is to describe the treatment of this illness in modern, realistic but optimistic terms. Admittedly there is little scientific content as yet, but there is more consensus on methodology than many professionals realise.