Delusional disorder

This is a very rare form of psychosis that causes a person to experience complex and often disturbed thoughts and delusions that are not true or based on reality.

What is it?

Previously known as paranoid disorder, delusional disorder is marked by an individual’s inability to distinguish what is real from what is imagined. The delusions may be misinterpretations of experienced events, and are either not true or highly exaggerated. They may be nonbizarre and relate to situations that could occur, such as being followed, poisoned, deceived, or loved from a distance, or may be bizarre delusions that are impossible, for example, a belief in an imminent alien invasion.Delusional disorder can make it hard for a person to concentrate, socialize, and live a normal life, because it can cause dramatic changes in a person’s behavior that result in conflict with those around them. Individuals may become so preoccupied with their delusions that their lives are disrupted. However, others continue to function normally and, apart from the subject of their delusion, do not behave in an obviously odd manner. Some people experience hallucinations— seeing, hearing, tasting, smelling, or feeling things that are not really there.Psychological disorders known to trigger delusional episodes include schizophrenia , bipolar disorder , severe depression or stress, and lack of sleep. General medical conditions that can cause them are HIV, malaria, syphilis, lupus, Parkinson’s, multiple sclerosis, and brain tumors. Misuse of substances such as alcohol or drugs can also trigger delusional episodes in some people.

How is it diagnosed?

A doctor will first take a complete medical history of the individual. They will ask about symptoms and will want to know how a delusion affects a person’s day-to-day functioning, any family history of mental health conditions, and details of medications and/or illegal substances a person has been taking.

Thematic delusions

Delusions are fixed beliefs that do not change, even when a person is presented with conflicting evidence, and characteristically follow particular themes (right). Individuals are likely to display the delusion for a month or longer, and most do not admit they are problematic. The person may appear completely normal as long as an outsider does not touch on the belief.

Somatic A person with these delusions has
physical or bodily sensations—for example, as a
result of believing
insects are crawling under their skin.

Erotomanic A delusion in which a person believes that another individual,
often someone famous, is in love with them; may lead to stalking behavior.

Grandiose An individual with grandiose
delusions believes they have a great unrecognized talent or
knowledge, for example, they may be a special messenger, guru, or God.

Persecutory A person with these
delusions feels that they are being persecuted or mistreated—for example, stalked, drugged, spied on, or the victim of slander.

Jealous People with this delusion have a
morbid but unfounded belief that their partner has been unfaithful or is deceiving them.

Mixed or unspecified

Themes are said to be mixed Jealous People with this delusion have a
morbid but unfounded belief that their partner has been unfaithful or is deceiving them.
if several types of delusions are present but no particular one
predominates. In some cases the delusion does not fall into any of the main categories and is unspecified.

TREATMENT

❯ Medication prescribed may include antipsychotic drugs to reduce the delusional symptoms and antidepressants such as selective serotonin reuptake inhibitors (SSRIs) to help with the depression that can be associated with the disorder.

❯ Psychotherapies such as cognitive behavioral therapy to help examine the strongly held beliefs and support changes needed.

❯ Self-help groups and social support to reduce the stress that results from living with this disorder and to help those around them, and family, social, and/or school intervention to help develop social skills to reduce the impact of the disorder on quality of life.