Signs of delusion
Causes, Symptoms, Types & Treatment
Overview
What is delusional disorder?
Delusional disorder is a type of psychotic disorder. Its main symptom is the presence of one or more delusions.
A delusion is an unshakable belief in something that’s untrue. The belief isn’t a part of the person’s culture or subculture, and almost everyone else knows this belief to be false.
People with delusional disorder often experience non-bizarre delusions. Non-bizarre delusions involve situations that could possibly occur in real life, such as being followed, deceived or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, these situations are either untrue or are highly exaggerated.
Non-bizarre delusions are different from bizarre delusions, which include beliefs that are impossible in our reality, such as believing someone has removed an organ from your body without any physical evidence of the procedure.
People with delusional disorder often continue to socialize and function well, apart from the subject of their delusion. Generally, they don’t behave in an odd or unusual manner. This is unlike people with other psychotic disorders, who might also have delusions as a symptom. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
What are the types of delusional disorder?
There are different types of delusional disorder, which are determined based on the main theme of the delusions the person experiences. The types of delusional disorder include:
- Erotomanic: People with this type of delusional disorder believe that another person, often someone important or famous, is in love with them. They may attempt to contact the person of the delusion and engage in stalking behavior.
- Grandiose: People with this type of delusional disorder have an overinflated sense of self-worth, power, knowledge or identity.
They may believe they have a great talent or have made an important discovery. - Jealous: People with this type of delusional disorder believe that their spouse or sexual partner is unfaithful without any concrete evidence.
- Persecutory: People with this type of delusional disorder believe someone or something is mistreating, spying on or attempting to harm them (or someone close to them). People with this type of delusional disorder may make repeated complaints to legal authorities.
- Somatic: People with this type of delusional disorder believe that they have a physical issue or medical problem, such as a parasite or a bad odor.
- Mixed: People with this type of delusional disorder have two or more of the types of delusions listed above.
What is the difference between delusional disorder and schizophrenia?
Schizophrenia is a spectrum (or range) of conditions that involve psychotic symptoms, which include:
- Disorganized speech or behavior.
- Negative symptoms (a decrease in emotion in a person’s facial expressions and motivation).
Delusional disorder is different from schizophrenia because there aren’t any other psychotic symptoms other than delusions.
In addition, in contrast to schizophrenia, delusional disorder is relatively rare, and daily functioning isn’t as impaired as it is in schizophrenia.
Who does delusional disorder affect?
Delusional disorder most often occurs in middle to late life, with the average age of onset being 40 years.
The persecutory and jealous types of delusional disorder are more common in people assigned male at birth (AMAB), and the erotomanic type is more common in people assigned female at birth (AFAB).
People who tend to be socially isolated are more likely to develop delusional disorder. These populations include:
- Immigrants who have language barriers.
- People who are deaf.
- People who are visually impaired.
- Elderly people.
How common is delusional disorder?
Although delusions might be a symptom of more common disorders, such as schizophrenia, delusional disorder itself is rather rare. Approximately 0.05% to 0.1% of the adult population has delusional disorder.
What is the most common type of delusional disorder?
The most common type of delusional disorder is the persecutory type — when someone believes others are out to harm them despite evidence to the contrary.
Symptoms and Causes
What are the signs and symptoms of delusional disorder?
The presence of delusions is the most obvious sign of delusional disorder, which vary based on the type.
Another characteristic of this condition is that the person often lacks self-awareness that their delusions are problematic. They’re unable to accept that their delusions are irrational or inaccurate, even if they recognize that other people would describe their delusions this way.
Anger and violent behavior may be present if someone is experiencing persecutory, jealous or erotomanic delusions.
People with delusional disorder may also develop anxiety and/or depression as a result of the delusions.
Early symptoms of delusional disorder may include:
- Feelings of being exploited.
- Preoccupation with the loyalty or trustworthiness of friends.
- A tendency to read threatening meanings into benign remarks or events.
- Persistently holding grudges.
- A readiness to respond and react to perceived slights.
What causes delusional disorder?
As with many other psychotic disorders, researchers don’t yet know the exact cause of delusional disorder. Researchers are, however, looking at the role of various factors that may contribute to the development of the condition, including:
- Genetic factors: The fact that delusional disorder is more common in people who have family members with delusional disorder or schizophrenia suggests there might be a genetic factor involved. Researchers believe that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their biological children.
- Biological factors: Researchers are studying how abnormalities of certain areas of your brain might be involved in the development of delusional disorder. An imbalance of certain chemicals in your brain, called neurotransmitters, has been linked to the formation of delusional symptoms.
- Environmental and psychological factors: Evidence suggests that delusional disorder can be triggered by stress. Alcohol use disorder and substance use disorder might contribute to the condition. Hypersensitivity and ego defense mechanisms like reaction formation, projection and denial are some psychodynamic theories for the development of delusional disorder. Social isolation, envy, distrust, suspicion and low self-esteem are also some psychological factors that may lead to a person seeking an explanation for these feelings and, thus, forming a delusion as a solution.
Diagnosis and Tests
How is delusional disorder diagnosed?
Healthcare providers — mainly mental health professionals — diagnose delusional disorder when a person has one or more delusions for one month or more that can’t be explained by any other condition.
The person must also not have the characteristic symptoms of other psychotic disorders, such as schizophrenia.
If someone is experiencing signs and symptoms of delusional disorder, a healthcare provider will perform a complete medical history and physical examination. Although there aren’t any laboratory tests to diagnose delusional disorder, their healthcare provider might use various diagnostic tests — such as imaging tests, a urine drug screen and blood tests — to rule out any physical conditions, medications or substances that could be causing the symptoms.
If their healthcare provider finds no physical reason for the symptoms, a consultation with a psychiatrist or psychologist will likely be made. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. They’ll ask questions about the delusions and assess the person’s mental status.
The psychiatrist or psychologist may also interview family members and friends so they can provide further details about the person’s delusions and a timeline of the symptoms.
As other mental health conditions can cause delusions, mental health professionals carefully assess the person for other symptoms. Delusional disorder can be misdiagnosed as any of the following conditions:
- Obsessive-compulsive disorder.
- Schizophrenia.
- Delirium/major neurocognitive disorder.
- Bipolar disorder.
- Personality disorders, especially borderline personality disorder and paranoid personality disorder.
Management and Treatment
How is delusional disorder treated?
Treatment for delusional disorder most often includes psychotherapy (talk therapy) and medication, but delusional disorder is highly resistant to treatment with medication alone.
People with delusional disorder often don’t seek treatment for the condition on their own because most people with delusional disorder don’t realize their delusions are problematic or incorrect. It’s more likely they’ll seek help due to other mental health conditions such as depression or anxiety.
People with severe symptoms or who are at risk of hurting themselves or others might need to be admitted to the hospital until the condition is stabilized.
Psychotherapy for delusional disorder
Psychotherapy is a term for a variety of treatment techniques that aim to help people identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to the person and their family.
Through therapy, people with delusional disorder can learn to manage their symptoms, identify early warning signs of relapse and develop relapse prevention plans. Types of psychotherapy include:
- Individual psychotherapy: This type of therapy can help a person recognize and correct the underlying thinking that has become distorted.
- Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of therapy.
A mental health professional helps people take a close look at their thoughts and emotions. They’ll come to understand how their thoughts affect their actions. Through CBT, they can unlearn negative thoughts and behaviors and learn to adopt healthier thinking patterns and habits. - Family-focused therapy: This therapy can help people with delusional disorder and their families. This treatment involves psychoeducation regarding delusional disorder, communication improvement training and problem-solving skills training.
Medications for delusional disorder
The primary medications used to help treat delusional disorder are called antipsychotics (neuroleptics). Medications include the following:
- First-generation (“typical”) antipsychotics: Healthcare providers have used these medications to treat mental health conditions since the mid-1950s. These medicines work by blocking dopamine receptors in your brain. Dopamine is a neurotransmitter believed to be involved in the development of delusions.
First-generation antipsychotics include chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), thiothixene (Navane®), trifluoperazine (Stelazine®), perphenazine (Trilafon®) and thioridazine (Mellaril®). - Second-generation (“atypical”) antipsychotics: These newer antipsychotics are also effective in treating the symptoms of delusional disorder. They work by blocking dopamine and serotonin receptors in your brain. These drugs include risperidone (Risperdal®), clozapine (Clozaril®), quetiapine (Seroquel®), ziprasidone (Geodon®) and olanzapine (Zyprexa®). These medications are usually better tolerated than first-generation antipsychotics.
Other medications that healthcare providers might prescribe to treat delusional disorder include anxiolytics and antidepressants. Anxiolytics might help if the person has a very high level of anxiety and/or problems sleeping. Antidepressants can help treat depression, which often occurs in people with delusional disorder.
Prevention
Can delusional disorder be prevented?
There’s no known way to prevent delusional disorder. However, early diagnosis and treatment can help decrease the disruption to the person’s life, family and friendships.
Outlook / Prognosis
What is the prognosis (outlook) for delusional disorder?
The prognosis (outlook) for people with delusional disorder varies depending on a few factors, including:
- The type of delusional disorder.
- The severity of the delusions.
- The person’s life circumstances, including the availability of support and a willingness to stick with treatment.
Delusional disorder doesn’t usually significantly affect a person’s daily functioning, but the severity of the delusion may gradually get worse. Most people with delusional disorder can remain employed as long as their work doesn’t involve things related to their delusions.
The prognosis of delusional disorder is better if the person sticks to their treatment plan.
Almost 50% of people have a full recovery, more than 20% of people report a decrease in symptoms and less than 20% of people report minimal to no change in symptoms.
Unfortunately, many people with this condition don’t seek help. It’s often difficult for people with mental health conditions to recognize they’re not well. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long condition.
What are the possible complications of delusional disorder?
If left untreated, delusional disorder might lead to:
- Depression, often as a consequence of difficulties associated with the delusions.
- Social isolation.
- Legal issues — for example, stalking or harassing the person involved with the delusion could lead to arrest.
- Self-harm or harm to others. This is more common in the jealous and persecutory types.
Living With
How can I help someone with delusional disorder?
If you know someone with delusional disorder, you can help by providing support and encouragement for them to seek help and treatment.
People with delusional disorder who feel pressured or repeatedly criticized by others will likely experience stress, which may worsen their symptoms. Because of this, a positive approach may be more helpful and effective.
The friends and family members of people with delusional disorder often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
A note from Cleveland Clinic
It’s important to remember that delusional disorder is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help manage thoughts and behaviors.
Delusional Disorder Signs & Symptoms
The signs, symptoms, and effects of delusional disorder can look different for each person impacted. Learning about delusional disorder is one of the first steps toward healing.
Understanding Delusional Disorder
Learn about delusional disorder
A delusion is a belief that a person holds that is not based in reality and is not altered or modified when the person is presented with contradictory evidence. As such, people who are suffering from delusional disorder struggle to align reality with their perceptions of reality. There are a number of different delusions that a person may hold. Some individuals believe that another person is in love with him or her (the erotomanic type), while other people believe that they possess a great hidden talent or have a history of great achievements (the grandiose type). Still other people become convinced that a lover or spouse has been unfaithful (the jealous type), or that one is being pursued, hunted, attacked, persecuted, or prevented from achieving goals (the persecutory type). Other people develop delusions about their bodies or bodily sensations, such as believing that insects are inside of them or that they have a foul odor, which would indicate that they are suffering from the somatic type of the disorder.
Often a person with delusional disorder may behave in a relatively healthy, adaptive manner and only display odd behavior where his or her delusion is concerned. That being said, delusional disorder has the potential to create enormous upset and turmoil in a person’s life. Thankfully, there are treatment options available to help people manage the painful effects of delusion disorder.
Statistics
Delusional disorder statistics
According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, it is estimated that approximately 0.2 percent of people will suffer from delusional disorder at some point in their lives. Overall rates of delusional disorder are the same between men and women, though men are more likely to develop jealous-type delusions.
Causes and Risk Factors
Causes and risk factors for delusional disorder
Research suggests that people who have family members with schizophrenia or schizotypal personality disorder are at greater risk of developing delusional disorder, suggesting that genetics may play a causal role in determining a person’s risk of developing the disorder.
In addition, people who are older are more likely than younger individuals to develop delusional disorder as well.
Risk Factors:
- Family history of schizophrenia or schizotypal personality disorder
- Being of older age
Signs and Symptoms
Signs and symptoms of delusional disorder
The signs and symptoms of delusional disorder differ primarily according to personality differences and the type of delusion with which a person is struggling. These symptoms also must not be due to consumption of a drug or other substance. Despite individual differences in the disorder, the following are some common signs and symptoms of delusional disorder:
Behavioral symptoms:
- Antagonistic behavior, such as filing lawsuits or sending many letters of protest
- Aggressive behavior towards others that is consistent with delusions
- Other behaviors that are consistent with delusions, such as scratching one’s skin if one believes one’s body is infested with insects
- Poor occupational functioning directly related to the delusional belief
- Relative lack of impairment in functioning other than that caused by the delusion
Cognitive symptoms:
- Experiencing a delusion or delusions
- Poor insight into irrationality of one’s delusional belief(s)
- Believing that others are attempting to harm the person (persecutory type)
- Belief that others are in love with the person (erotomanic type)
- Belief that one has great talents or a history of important achievements (grandiose type)
- Believing that one’s spouse or significant other is unfaithful (jealous type)
- Belief that one’s body has a foul odor, is malfunctioning or misshapen, or is infested (somatic type)
- Other delusional belief (mixed or unspecified type)
- Lack of bizarre or odd beliefs other than the delusion
Psychosocial symptoms:
- Social difficulties related to one’s delusion(s)
- Tension in romantic relationships related to the delusion(s)
- Irritability
Effects
Effects of delusional disorder
Delusional disorders tend to have less of an effect on a person’s overall ability to function than other schizophrenia spectrum or psychotic disorders.
However, if a person’s delusional beliefs come to the surface in multiple settings, the potential for negative effects is much greater. If delusional disorder is left untreated, the following are some potential negative consequences that a person may experience:
- Disruption in social relationships
- Social isolation
- Tension with one’s spouse or significant other
- Poor work performance
- Loss of job
- Financial difficulties
- Onset or worsening of mental health symptoms
- Irritability
- Anger or violent behavior
- Legal difficulties
Delusional Disorder Treatment
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Treatment of delusions and delusional disorders
The treatment of delusions and delusions is one of the leading tasks for psychiatrists, since this condition is very common. Pathology can take many forms: for example, a delusional disorder can include delusions of grandeur, persecution, jealousy, and dozens of other options.
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Treatment of delirium in the Krasnogvardeisky district
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From the point of view of medicine, a distorted perception of reality is a symptom of many psychotic illnesses associated with disorders of the brain. This is a mental disorder in which a person holds beliefs that do not correspond to reality and makes erroneous conclusions that cannot be corrected, since they seem to him logical and the only true ones. These "three whales" (inconsistency with reality and at the same time a person's conviction in the logic and correctness of his own conclusions) are defined in 1913, when a detailed study of this pathology began.
Often illusory perception is worked out in detail, it has a system of personal internal proofs for a person. So, a person can “recharge” from the network if he considers himself a battery, and will really feel a surge of energy or will be able to do without products that he considers dangerous for himself for a long time. The treatment of a delusional disorder (for example, it can be a common delusion of jealousy) is always associated with overcoming the internal resistance of a person.
Basic Scenarios of Distorted Consciousness
Medicine identifies three common scenarios of distorted perception. These are paranoid, paranoid and paraphrenic syndromes.
In the paranoid syndrome, hallucinations and adherence to one topic are observed.
Paranoid syndrome is characterized by obsession with one topic; beyond its limits, human thinking remains undistorted.
Paraphrenic syndrome is distinguished by a person's fanatical conviction and systematized distortion of perception.
Causes of the onset and development of the disease
The exact causes of the disease have not been established. It is known that the condition can develop under the influence of the following factors:
- Genetic predisposition. The presence of mental disorders in close blood relatives.
- Endogenous factor. Imbalance of specific neurotransmitter substances in the human brain.
- External influences. The "trigger" for the development of pathology can be alcoholism, drug addiction, stress, failures in personal life.
Diagnostics
Treatment of delusional disorders (such as paranoid delusions) begins with diagnosis. The analysis of the state is not easy, since the treatment of delusions begins only when the person's strange judgments become clearly visible to others. It doesn't happen right away. Manifestations increase gradually and for a long time are interpreted by relatives as features of human thinking.
To establish a diagnosis, the patient's history is examined, and all external manifestations of mental illness are compared with recognized diagnostic criteria. Among them are such as:
- Paralogic. Illusions are based on internal painful logic.
- Preservation of consciousness. A person remembers his data, recognizes his relatives, navigates the city, reads and writes.
- Conviction. A person is convinced that he is right, and it is impossible to shake his conviction by giving logical arguments.
- Egocentrism. A person is focused on his own personality and the habitual plot of distorted perception.
Treatment of delusional disorders
Clinics of the Dynasty network use classical proven technologies in combination with new psychological approaches to help patients with this pathology.
The treatment of delusions is based on delusions of persecution, jealousy, invention, depressive delusions, etc.
- use of medications and psychotherapy.
The therapy regimen uses modern psychotropic antipsychotics, as well as antidepressants and, in some cases, tranquilizers.
Sensitive specialists of clinics treat each patient carefully and prescribe complex psychotherapy to switch attention to constructive ideas. Behavioral therapy is used, relatives are recommended to protect a person from stress.
In severe cases, it is possible to hospitalize the patient in a comfortable private hospital network "Dynasty" for the speedy normalization of the condition.
Reception by doctors:
Choose the Dynasty branch on Novocherkassky avenue, Krasnogvardeisky districtDynasty on Lenina street, Petrogradsky districtDynasty on Repishcheva street, Primorsky districtDynasty in VsevolozhskVisiting service
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Consults online
Cost of delusion treatment:
| Service name | Price in rubles | |
St. Petersburg | Vsevolozhsk | |
| Psychological consultation | from 3000 | from 2500 |
| Psychiatric consultation | from 3500 | from 3000 |
| Psychotherapist's consultation | from 3500 | from 4000 |
| Sexologist consultation | 4500 | 4500 |
| Narcologist consultation | from 3000 | from 4000 |
| Family therapy session | from 3500 | from 3500 |
| Group psychotherapy session | 1800 | - |
| Psychiatric report for reference | 1000 | 1000 |
| Psychodiagnostic examination (2 hours) | 6000-7000 | 6000-7000 |
| Wechsler test | 5000 | - |
| Psychotherapeutic consultation | 11000 | 11000 |
| Psychiatric examination before the transaction | 9000 | 9000 |
| Psychiatric hospital | ||
| Standard (4-seat) | - | 6000 |
| Standard+ (2-seat) | - | 7500 |
| Junior suite (2 persons) | - | 8300 |
| Suite (2 persons) | - | 9000 |
| Premium (single) | - | 10500 |
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The concept of delirium, definition, classification, objective signs of delirium, socially dangerous forms of delirium and tactics of a general practitioner in their detection. Delirium ( lat. Delirium ) - a collection of ideas and ideas, conclusions, arising not from those coming from the surrounding world information and not corrected at the same time by the incoming new information (it does not matter if whether the delusional inference reality or not) component productive symptoms with schizophrenia and other psychoses .
AT within medicine, delusion refers to area psychiatry .
Fundamentally it is important that delirium, being a disorder of thinking , i.e. psyche , at the same time - symptom of the disease of the head brain of people. Treatment of delusions, according to ideas modern medicine, perhaps only biological methods, that is, mostly drugs (e.
g. antipsychotics ).
Rave distinguished from the syndrome Kandinsky -Clerambault ( syndrome mental automatism ), in which thought disorders associated with pathology of perception and ideomotor .
Classification
Spicy delirium
If a delirium completely takes over consciousness , then this condition is called acute delirium. Sometimes the patient is able to adequately analyze the surrounding reality if it does not concern the subject of delirium. Such nonsense is called encapsulated.
Being productive psychotic symptoms, delirium is a symptom of many brain diseases, but especially characteristic for schizophrenia .
Interpretive (Primary, Primordial, Verbal)
At interpretive delirium primary is the defeat of thinking - is amazed rational, logical knowledge, distorted judgment consistently supported by a number of subjective evidence that has its own system.
This type of delirium is persistent and a progressive trend and systematization : "evidence" comes down to subjectively harmonious system (at the same time everything that does not fit into this system, simply ignored), all large parts of the world are being drawn into a delusional system.
Hallucinatory (Secondary, Sensual, Explanations)
Hallucinatory delusion, arising from impaired perception . This is figurative nonsense, with predominance of illusions and hallucinations . His ideas are fragmented, inconsistent - primary violation of the sensory knowledge ( perception ). Violation of thinking occurs secondarily, there is a delusional interpretation hallucinations, lack of inference, which are carried out in the form of insights - bright and emotionally rich insights. Another reason for the development secondary delusions can become affective disorders. Manic state causes delusions of grandeur, and depression is root cause of ideas of self-abasement.
Elimination of secondary delirium succeeds achieved mainly by treatment underlying disease or symptom complex.
Fabula delirium, those. main content delusional concepts, can take the most various forms. delusional judgments patients are subjective and practically unique, but they reflect prevailing ideas in society. Yes, in 19th century were very common delusional ideas of religious content, and the development of sciences in the 20th century, which caused the appearance a huge number of new technical ideas, led to the emergence of delirium, in which persecution appears by aliens, interference in the work of the brain with the help of computers technologies, the influence of lasers, psychics etc. Yet in a variety of delusional ideas, some of the main concepts that are repeated in different sick. The most successful classification plot of nonsense based on ideas W. Grezinger, includes delusions of persecution (persecutory), depressive and grandeur (Table 5.
1). Often, one patient see a combination of several plots.
Various options persecutory delusion associated with the predominance of patients anxiety and fear, often ag-
Table 5.1. The main plots of delusions and their clinical options
| Rave pursuit (persecutory) | Depressive delirium | Rave greatness |
| Actually persecution Exposure Poisoning Material damage Litigation Relations (of special significance) Dramatizations Jealousy | Self-deprecation Self-blame Sinfulness And pochondriac Dysmorphomanic cue | wealth Inventions of the Reformation High Origin Love |
aggressive behavior of patients and in this case are indications for involuntary hospitalizations.
special danger represents the situation of "persecuted pursuer" when the patient chooses among those around a person who, according to in his opinion, is his offender, and starts actively pursuing him.
Actually delusions of persecution is to convince the patient that that imaginary pursuers walk on his heels, watching his life from the windows of neighboring houses, penetrate into apartment in his absence, check his business papers and letters follow him everywhere he goes. Delirium impact differs in that, according to patients, persecution is carried out through complex technical means (beams, devices, tape recorders, microprocessors, electromagnetic fields) or by remote psychological impact (hypnosis, telepathy, witchcraft, psychic influences). Delusion impact is an important part syndrome of mental automatism (see section 5.3) and is especially important in the diagnosis schizophrenia. Patients with delusions of poisoning are sure that they are sprinkled with food poison or poisonous gases.
Often this is accompanied by taste or olfactory hallucinations. Rave poisoning occurs not only in schizophrenia, but sometimes occurs in patients with involutionary psychoses.
FROM old age is associated with the appearance of delirium of material damage, expressed in the idea that the persecutors allegedly steal food, spoil things, beat dishes, undermine furniture. Some patients at the same time apply to various authorities complaints and demands (litigious nonsense). Young patients have similar ideas practically never occurs.
Special of interest are the plots of delirium, indicating an acute, rapidly developing the nature of the disease. At delirium relationship (of particular importance) random facts reality are perceived as important symbols that carry great semantic load and having directly related to life sick. In this case, a smile on your face a random passerby, a barking dog, the appearance of a new car in the yard - everything convinces the patient of the presence of danger, hostility, sometimes direct threat to his life.
