Delusions examples schizophrenia

Symptoms - Schizophrenia - NHS

Schizophrenia changes how a person thinks and behaves.

The condition may develop slowly. The first signs can be hard to identify as they often develop during the teenage years.

Symptoms such as becoming socially withdrawn and unresponsive or changes in sleeping patterns can be mistaken for an adolescent "phase".

People often have episodes of schizophrenia, during which their symptoms are particularly severe, followed by periods where they experience few or no symptoms. This is known as acute schizophrenia.

Positive and negative symptoms

The symptoms of schizophrenia are usually classified into:

positive symptoms – any change in behaviour or thoughts, such as hallucinations or delusions

negative symptoms – where people appear to withdraw from the world around then, take no interest in everyday social interactions, and often appear emotionless and flat

Hallucinations

Hallucinations are where someone sees, hears, smells, tastes or feels things that do not exist outside their mind. The most common hallucination is hearing voices.

Hallucinations are very real to the person experiencing them, even though people around them cannot hear the voices or experience the sensations.

Research using brain-scanning equipment shows changes in the speech area in the brains of people with schizophrenia when they hear voices. These studies show the experience of hearing voices as a real one, as if the brain mistakes thoughts for real voices.

Some people describe the voices they hear as friendly and pleasant, but more often they're rude, critical, abusive or annoying.

The voices might describe activities taking place, discuss the hearer's thoughts and behaviour, give instructions, or talk directly to the person. Voices may come from different places or 1 place, such as the television.

Delusions

A delusion is a belief held with complete conviction, even though it's based on a mistaken, strange or unrealistic view. It may affect the way the person behaves. Delusions can begin suddenly or may develop over weeks or months.

Some people develop a delusional idea to explain a hallucination they're having. For example, if they have heard voices describing their actions, they may have a delusion that someone is monitoring their actions.

Someone experiencing a paranoid delusion may believe they're being harassed or persecuted. They may believe they're being chased, followed, watched, plotted against or poisoned, often by a family member or friend.

Some people who experience delusions find different meanings in everyday events or occurrences.

They may believe people on TV or in newspaper articles are communicating messages to them alone, or that there are hidden messages in the colours of cars passing on the street.

Confused thoughts (thought disorder)

People experiencing psychosis often have trouble keeping track of their thoughts and conversations.

Some people find it hard to concentrate and will drift from one idea to another. They may have trouble reading newspaper articles or watching a TV programme.

People sometimes describe their thoughts as "misty" or "hazy" when this is happening to them. Thoughts and speech may become jumbled or confused, making conversation difficult and hard for other people to understand.

Changes in behaviour and thoughts

A person's behaviour may become more disorganised and unpredictable.

Some people describe their thoughts as being controlled by someone else, that their thoughts are not their own, or that thoughts have been planted in their mind by someone else.

Another feeling is that thoughts are disappearing, as though someone is removing them from their mind.

Some people feel their body is being taken over and someone else is directing their movements and actions.

Negative symptoms of schizophrenia

The negative symptoms of schizophrenia can often appear several years before somebody experiences their first acute schizophrenic episode.

These initial negative symptoms are often referred to as the prodromal period of schizophrenia.

Symptoms during the prodromal period usually appear gradually and slowly get worse.

They include the person becoming more socially withdrawn and increasingly not caring about their appearance and personal hygiene.

It can be difficult to tell whether the symptoms are part of the development of schizophrenia or caused by something else.

Negative symptoms experienced by people living with schizophrenia include:

losing interest and motivation in life and activities, including relationships and sex
lack of concentration, not wanting to leave the house, and changes in sleeping patterns
being less likely to initiate conversations and feeling uncomfortable with people, or feeling there's nothing to say

The negative symptoms of schizophrenia can often lead to relationship problems with friends and family as they can sometimes be mistaken for deliberate laziness or rudeness.

Psychosis

Schizophrenia is often described by doctors as a type of psychosis.

A first acute episode of psychosis can be very difficult to cope with, both for the person who is ill and for their family and friends.

Drastic changes in behaviour may occur, and the person can become upset, anxious, confused, angry or suspicious of those around them.

They may not think they need help, and it can be hard to persuade them to visit a doctor.

Read more about understanding psychotic experiences.

Schizophrenia Delusions: Definition, Types, and Treatments

Beliefs That Aren’t Real: How Doctors Define Schizophrenia Delusions

Schizophrenia is a severe mental health condition that can cause a number of symptoms, including problems thinking clearly, hallucinations, and delusions.

Those with schizophrenia often experience symptoms doctors describe as positive, negative, or cognitive (or a combination of each). ¹ Delusions are an example of a positive symptom along with hallucinations. Negative symptoms include lack of emotional response while cognitive symptoms include difficulty communicating with others.

This article will describe what delusions are, how they affect a person with schizophrenia, and how a doctor will treat the delusions.

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What are delusions?

Schizophrenia delusions are a schizophrenia symptom that causes a person to believe something that isn’t true — even when others try to tell them or show them their beliefs are untrue.¹ Specifically, the Diagnostic and Statistical Manual of Mental Disorders 5, Text Revision (DSM-5-TR), define delusions as “fixed believes that are not amenable to change in light of conflicting evidence.”²

The DSM-5-TR names delusions as one of the five key criteria mental health experts use to diagnose schizophrenia.²

A common schizophrenia delusion type is the paranoid delusion. ¹ Another word for these are persecutory delusions. These are delusions where a person believes they are being harassed, harmed, or otherwise watched by others. Examples of paranoid schizophrenia delusions may include:

”The FBI are following me.”
”My spouse is trying to poison me.”
“My family is pumping medicine through the air conditioner to try and make me look crazy.”

Additional Schizophrenia Delusion Types

Paranoid delusions aren’t the only schizophrenia delusion type. Schizophrenia delusions examples may include^2,3:

Delusions of control: A person believes others are trying to control their thoughts or behaviors. An example would be: ”My doctor is trying to plant thoughts inside my head.”
Delusions of erotomania: A person with this delusion type believes that another person or persons are in love with them. An example would be “Taylor Swift is in love with me and writes me love letters every day. ”
Delusions of grandeur: A person believes they are a historical figure of great importance. An example would be: “I am the reincarnation of Julius Caesar.”
Delusions of reference: A person believes that messages are for them, such as something on a billboard, on the television, or in a movie. An example would be: “The President is speaking directly to me through the television.”

In one study of patients with schizophrenia delusions, delusions of reference were the most common delusion type, followed closely by persecutory delusions.³ However, some studies find persecutory delusions are the most common type. A person can experience multiple delusion types.

Doctors may call delusions “bizarre” if they are so implausible that they are difficult to understand or interpret.

Schizophrenia Delusions Treatments

Doctors may have a hard time helping a person treat delusions because the person doesn’t recognize their thoughts or beliefs are incorrect. They will use both pharmacological and non-pharmacological treatments, which include:⁴

Non-pharmacological Treatments

Cognitive behavioral therapy
Group therapy
Social skills therapy
Vocational/employment rehabilitation

Non-pharmacological treatments are important in treating schizophrenia and delusions because traditionally patients with schizophrenia have poor adherence to their medications.⁴ Using non-pharmacological approaches can help improve treatment adherence.

Pharmacological Treatments

First-line treatments for maintenance are second-generation atypical anti-psychotics, such as aripiprazole, risperidone, and ziprasidone
First-generation anti-psychotics usually cause more severe symptoms and aren’t first-line treatments. They include chlorpromazine and haloperidol
Doctors may prescribe clozapine, a second-generation atypical anti-psychotic, for treatment-resistant schizophrenia. This medication can cause more side effects than other anti-psychotics (including increased risks for seizures)

When a mental health professional is establishing a therapeutic environment with a client who experiences delusions, it’s important that they recognize how the delusion may make their client feel. Some clients may find their delusion is scary or makes their client feel unsafe. While they should not validate the delusion, validating how the delusion makes the client feel can be important.

Call to Action: Ready to dig deeper into delusions associated with schizophrenia? Symptom Media’s accredited CE course includes an in-depth discussion of these delusions as well as both pharmacological and non-pharmacological treatments.

Written by Rachel Nall, RN, MSN, CRNA

Crazy ideas (strange judgments, delirium)

Most often they are perceived by relatives and others as strange judgments that do not correspond to reality. At the same time, a person with delusions cannot be persuaded, even if he does not know what to object to attempts to persuade him. Crazy ideas don't need proof. It is rather "knowledge", conviction. Because of this, the behavior of a person with delusional ideas is determined by the content of these ideas. According to the content, the main forms of delusions can be divided into delusions of persecution (what is popularly called “persecution mania”: the patient is pursued by special services or other organizations, they try to poison or rob relatives or neighbors; people on the street somehow in a special way, look unfriendly and whisper about him), delusions of grandeur (the patient is the heir to the royal family, the inventor of the time machine or the law of immortality, the ruler of the world, sometimes the messenger of God or God himself, or the devil, etc.) and delusions of self-abasement (accusing oneself of sins, numerous errors, delirium of a physical defect). A patient with delusional judgments needs to be treated by a psychiatrist. nine0003

It is important to be able to distinguish delusional ideas from prejudices, superstitions and erroneous unshakable judgments that are characteristic of absolutely healthy people. If a person believes in psychics, healers, witches and sorcerers, this does not mean that pathological processes are taking place in his psyche that affect the thinking of this individual, and you should immediately contact a psychiatrist. It is rather the person’s environment that inspired him with these false judgments, which prevent him from sensibly perceiving some of the events of our life, is to blame. nine0003

Limited knowledge also contributes to the development of the superstition of the individual, in the Middle Ages, almost the entire population of the earth was superstitious, and all because of the lack of any natural knowledge about the world and the universe. Most often in the process of enlightenment, a superstitious person admits the fallacy of his judgments and accepts a scientifically proven point of view. A person possessed by delusional ideas can stop persisting in his strange judgments only after the cessation of the pathological process of the patient sitting in the psyche. nine0003

Crazy ideas or delusions are dangerous due to their obsession and require close attention of specialists to the patient in order to avoid unpredictable situations and dangerous consequences.

Delusional disorders are speech that causes confusion and confusion. A person's statements do not correspond to reality, his interpretations of what is happening do not correspond to generally accepted ones, he also forms false beliefs over a significant period of time. A subtle point in diagnosing a delusional disorder is determining how delusional reality does not correspond to the consensus reality, the opinion of the majority. This subtle point was a vulnerability of psychiatry, since the diagnosis made it possible to persecute a person and treat him with political opinions different from the generally accepted ones. Now, when people allow pluralism of opinions, there are still such areas of social tension and tension of opinions in which people's judgments and statements may seem strange and similar to delusional. nine0003

Delirium is a syntactically coherent speech, subject to a certain logic, sometimes not at all obvious to others, but inherent in a sick person. Delusional disorder is one of the symptoms of schizophrenia, but sometimes it manifests itself as an independent manifestation; without schizophrenia, delusional disorder is less common. Delirium can be caused by clouding of consciousness during poisoning, at a high temperature, for example, with influenza, and then, with recovery, the person stops delirious. In everyday life, delusional disorder is diagnosed on average, more often in old age. nine0003

Crazy ideas most often do not look special, quasi-scientific or eccentric, but are somehow connected with the situations of the patient's former and present life, it can be persecution, fear of getting sick with something contagious, love experiences, deception on the part of the spouse. When asked to substantiate a crazy idea, the patient can apply a whole system of evidence, sometimes illogical.

The most common erotomaniac nonsense about love for a suffering person on the part of someone. How to notice nonsense? Well, for example, the gesture of a film actor in the cinema is interpreted as a sign of attention, love. A person's behavior, due to a delusional idea, may include acts of persecution, surveillance, writing love letters, sometimes going beyond the law. nine0003

If a person suffers from delusions of grandeur , he is convinced that he has a significant and undiscovered talent or has made an important scientific discovery.

Delirium of jealousy , a person is convinced that his spouse is unfaithful to him. At the same time, the facts that prompt the patient to believe so are misunderstood, distorted or hypertrophied. From ordinary jealousy, delirium is distinguished by its pretentiousness, absurdity. For example, if a footprint in front of the door or the appearance of a man on the stairwell leads to a chain of arguments about adultery, this is the delusion of jealousy. Such a disorder is quite dangerous, because of the real threat of physical violence against the “infidel”. nine0003

And, which has become a classic, delusions of persecution , sung by many literary works of the detective genre, with him a person thinks and expresses ideas that something evil is being planned against him, they are watching him in order to cause some harm. A patient with delusional persecution disorder strives for justice and turns to various institutions, sometimes at the wrong address. Delusional disorder with delusions of persecution is also dangerous, since the person suffering from it can commit violent acts. nine0003

There is also a dysmorphomania disorder, delusions about one's appearance, about a non-existent physical defect, about a bad smell or the presence of parasites. At the same time, the content of delusional ideas can be initiated by some kind of “norms of beauty”. Sometimes a minor defect hypertrophies and makes the patient unhappy. Currently, the beauty industry is facing a significant number of such people who are dissatisfied with their appearance. Such people, even after plastic surgery with a good outcome, are not satisfied. nine0003

The speech of a patient with a delusional disorder most often frightens others, making the sufferer an outcast, moving him away from real communication. In psychotherapy, as a rule, special techniques are used, for example, creating a safe space for delusions of persecution and vulnerability, the patient himself is allowed to take care of his security and asked to realize whether it has become safer, whether anxious expectations have decreased. Also helps to return to reality tactile contact and productive activities such as occupational therapy. Delusions as a symptom are reduced or disappear in the treatment of schizophrenia with medications. nine0003

Types of delusions in schizophrenia - Family Practice clinic

Among the symptoms characteristic of schizophrenia, delusion stands out separately - an acute condition in which the patient loses the ability to really realize what is really happening due to a painful distortion of the world around him. 8 out of 10 people diagnosed with schizophrenia have this symptom.

The occurrence of delusional states is directly caused by violations of either mental function or sensory perception. In this regard, it is customary to differentiate nonsense into primary secondary. nine0003

Consulting

Psychiatrist

Child psychiatrist

Psychotherapist

Group psychotherapy

Adolescent psychologist

Family psychologist

Family therapy

Classification of delusions

Primary (autochthonous) delusions are characterized by a violation of rational thinking and the loss of causal relationships. The patient interprets what is happening around him consistently, but extremely subjectively and even paradoxically. An obsessive belief is a consequence of an event and, accordingly, the primary symptom of a disease. However, cases are known in psychiatry when delusional perception arose spontaneously, without a specific cause or event. Primary delirium, having arisen once, with a high degree of probability, will have a relapse, which allows us to speak of it as a chronic phenomenon. nine0003

Treatment programs

Treatment of depression

Panic attacks

Treatment of schizophrenia

Neuroses, phobias

Secondary delirium is a consequence of a certain pathological experience, in which a violation of the sensory (figurative) perception of the world is recorded. It is expressed in the onset of an acute state of affect, the occurrence of severe hallucinations. Example: a patient develops hallucinations in which the "voice" of his deceased friend or relative speaks to him. Hallucinations are inexplicable, including from the standpoint of medical knowledge. The patient tries to explain to himself what is happening to him at a level accessible to him. So there is a delirium about communicating with a cast. nine0003

Diagnosis and treatment

Schizophrenia is not the only disease where delusions are one of the important symptoms. With other diseases, such as tumors, vascular disorders, fever, etc., a delusional state may also occur. For example, delusions are common in Fregoli syndrome, which is caused by damage to the right temporal lobe and fusiform gyrus.

It is not possible to self-diagnose schizophrenia. At the first suspicion of a disease, you should immediately contact the appropriate specialist. Psychiatric consultation involves a series of tests, neurophysiological examinations and MRI, allowing not only to establish an accurate diagnosis, but also to prescribe appropriate therapy. nine0003

“The disease won't go away on its own, treat your health responsibly. Are there any symptoms? Book a consultation with us."

Head physician Kharaburova TL

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