Signs of delusional behavior

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

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Delusional disorder - symptoms, causes, stages

Delusion or chronic delusional disorder refers to a person's false beliefs based on a misinterpretation of reality.

Although delusions can occur as part of other psychiatric disorders (such as schizophrenia, bipolar disorder), a diagnosis of delusional mental disorder is made only when delusional thoughts are the main and main symptom of the disease.

Disease Definition

Delusional disorder (ICD-10 code F22.0) is defined as a psychotic personality disorder in which a person has difficulty recognizing reality, resulting in delirium.

Sufferers of this disease firmly hold false beliefs despite clear evidence to the contrary. Their crazy ideas can be very diverse. The most common in delusional thought disorder are:

delusions of grandeur, in which one's own importance is overestimated;
delusion of guilt, when a person believes that he has committed a terrible serious crime;
delusions of jealousy with a predominance of the idea of committing adultery by a partner;
delusions of insertion and translation of thoughts, in which it seems that other people's thoughts are inserted into the person's mind;
somatic delusions, characterized by a belief in the presence of serious diseases and damage to internal organs;
delusions of persecution, when it seems that a person is being followed and a cruel crime is planned against him;
erotic or love delirium, characterized by the presence of thoughts that someone is in love with the patient;
litigious (Querulant) nonsense consists in a stubborn struggle for one's fictitious rights, which are allegedly violated.

There is also the concept of hypochondriacal delusional disorder, in which a person who has become disillusioned with medicine develops his own system of treatment and, thanks to it, “recovers”. Then he can promote it and “treat” other people who believe him.

Induced delusional disorder is a personality disorder in which delusions are shared by two or more persons with close emotional ties (eg, relatives).

The sick person's delusions may include circumstances that are impossible or unlikely in life. At the same time, delusional thoughts do not interfere with general logical reasoning and usually do not cause serious behavioral disorders.

People with delusional psychotic disorder usually do not have hallucinations or mood disorders. And if hallucinations do occur, they are part of a delusional belief. For example, a patient who has a delusion that his internal organs are rotting may hallucinate smells or sensations that are directly related to this delusion.

Symptoms of delusional personality disorder

The main symptom of a delusional disorder is the presence of strange, delusional thoughts in a person, which persist steadily for 3 months. Brad, at the same time, is built logically and internally consistent.

The main features of chronic delusional disorder include:

A person suffering from a delusional disorder expresses his belief or idea with extraordinary persistence and force.
His delusions are unlikely and do not correspond to social, cultural and religious status. Those who know the patient well argue that his beliefs and behavior are uncharacteristic and alien.
Delusional thoughts have an excessive impact on a person's life, as a result of which his lifestyle often changes beyond recognition.
The patient with delusional personality disorder becomes overly sensitive, especially about his beliefs, and also loses his sense of humor.
Although he is deeply convinced of his delusional ideas, he can become secretive and suspicious, especially when asked about his beliefs.
An attempt to refute a belief or idea causes an inappropriately strong emotional reaction in the patient, accompanied by irritability and hostility.
Delusions, if enacted, often result in abnormal and non-characteristic behavior.

Causes of Delusional Personality Disorder

The primary cause of delusional disorder is not exactly known. However, genetic, biochemical and environmental factors can play a decisive role in its development.

The main causes of this disease include:

biological factors. Brain abnormalities or chemical imbalances in the brain, traumatic brain injury, severe infectious disease, and alcohol and substance abuse can all contribute to organic delusional disorder.
Hereditary predisposition. This disease is more common in people who have relatives with mental illness (schizophrenia or delusional personality disorder).
Social factors. Social isolation, immigration, unemployment, low socioeconomic status can also be risk factors for the onset of the disease.
Cultural and religious factors. As a result of their influence, a person may develop spiritual, magical and religious delusions.
Old age and dementia. Delusional disorders in dementia are quite common. This is explained by the occurrence of a number of mental and behavioral disorders in the syndrome of senile dementia.
Impaired hearing or vision. Studies have shown that people with hearing or vision impairments are at a higher risk of developing psychosis and delusional states. One explanation is that hearing or vision impairments can lead to misinterpretations of the environment, causing people to perceive the world around them differently.
Serious traumatic situation, chronic exposure to stress.

Neurobiological factors play a key role in the pathogenesis of chronic delusional disorder.

Dysregulation of dopamine and other neurotransmitters is known to be associated with certain symptoms of this disease. Dopamine is a hormone and neurotransmitter that modulates motor control, motivation, and reward. Therefore, dysregulation of dopaminergic activity in the brain (namely, the occurrence of hyperactivity of dopamine receptors in some areas of the brain and underactivity in others) can lead to symptoms of acute delusional psychotic disorder.

There is also a psychological theory of the occurrence of delusional disorder. It's called the defense mechanism theory. It is hypothesized that delusions are the result of a defense mechanism aimed at maintaining a positive view of oneself by attributing negative properties to other people or circumstances.

Stages and classification of delusional personality disorder

There are two main stages of delusional personality disorder:

Acute delusional disorder. An acute condition begins unexpectedly (for example, after a head injury or meningitis). It is characterized by the brightness and severity of symptoms.
Chronic stage. This degree of delusional disorder is characterized by a slow development of the disease with irreversible changes. As a rule, they are discovered late, and some deviations in the patient's behavior are attributed to character traits or age.

In Russian psychiatric practice, it is customary to distinguish several types of delusional disorder:

Paranoia (paranoid personality disorder). The main feature of this condition is the presence of a chronic and pervasive distrust and suspicion of the patient towards the people around him. People with this disorder feel like everyone around them is lying. Patients are characterized by outbursts of anger, excessive control in relationships, negativism, sensitivity to criticism.
Late paraphrenia (involutional delusional disorder) - the common name for delusional psychoses that occur for the first time in adulthood (45-55 years), for a long time proceeding without pronounced personality changes. Characterized by the presence of paraphrenic delusions with fantastic ideas (usually delusions of grandeur or persecution). This type of delusional disorder is considered more severe than paranoia. It can be described as an intermediate link between paranoia and schizophrenia.
Paranoid schizophrenia with sensitive delusions of attitude. This is a disease with slowly developing and long-term delusions that do not develop into psychosis. Refers to delusional schizophrenia-like disorders. It manifests itself in the pathological beliefs of the patient that something that excites him in himself is also noticed by those around him. To some extent, this phenomenon is characteristic of most healthy, but shy people, especially those suffering from a physical inferiority complex. They themselves are constantly focused on such thoughts and are too afraid to discover some real, but greatly exaggerated shortcoming. However, with this type of disorder, these manifestations become overly pronounced. The attribution of people suffering from these symptoms to patients with schizophrenia causes a lot of doubt and controversy.
Other delusional disorder. This category includes: delusional dysmorphophobia, involutional paranoid state and querulant paranoia. Delusional dysmorphophobia is characterized by the patient's dissatisfaction with their appearance and delusional ideas about it. The involutional paranoid state is an senile paranoia that develops in adulthood and old age. The main manifestation of the involutionary paranoid is everyday delirium. Querulant paranoia is manifested by litigious activity, expressed in the struggle for one's rights and infringed interests (often imaginary or exaggerated).

Complications of delusional disorder

With inadequate medical treatment and the absence of a stable remission, the consequences of a chronic delusional disorder can be as follows:

depressed mood;
sleep disorders;
depression;
inability to build normal social contacts, love and family relationships;
unemployment;
decrease in the socio-economic standard of living;
aggressiveness, causing harm to others;
dangerous behavior.

The most serious complication of delusional disorder is the occurrence of suicidal thoughts and suicide.

The risk group for the occurrence of delusional disorders includes, first of all, persons of mature and elderly age with dementia, visually impaired and deaf, sensitive people with "magical thinking", as well as those who are in social isolation.

If they have unlikely delusions, false beliefs, strange behavior, suspicion, secrecy and distrust, you should definitely consult a doctor.

The sooner treatment, including pharmacotherapy, is started, the more favorable the prognosis will be. In addition, it will be possible to avoid many complications that affect both the patient himself and his family and environment.

Diagnosis of delusional mental disorder

Since the disease "delusional personality disorder" is quite rare, the doctor, first of all, evaluates the possibility of the patient having other serious mental illnesses with similar symptoms.

Differential diagnosis of delusional disorder is also carried out in order to exclude suspicions of the somatic nature of the disease. With similar symptoms, Alzheimer's and Parkinson's disease, brain tumors, epilepsy and others can occur.

The age of the patient must be taken into account. Older people who develop dementia often become delusional.

Diagnosis of a delusional disorder can be difficult if the patient hides his thoughts, and relatives brought him to the doctor. Since the victim is convinced of the reality of his ideas, he may refuse to accept his diagnosis and be treated.

The attending physician may prescribe various diagnostic tests of the brain, such as electroencephalography, magnetic resonance or computed tomography.

Treatment of delusional personality disorder

Treatment of delusional disorder is a responsible task for the doctor, the patient and his relatives.

People with this disorder usually do not admit that their beliefs or ideas are delusional and therefore rarely seek medical help. It is quite difficult for a doctor to establish contact and a therapeutic relationship with them.

The most effective treatment for the disorder is drug therapy with antipsychotics. Antipsychotic drugs help to stop psychotic symptoms and “interrupt” delusions by acting on dopamine and serotonin receptors in the brain.

Given that delusional states of the disorder usually develop in late adulthood, the most rational treatment is the use of atypical antipsychotics. Improvement after starting antipsychotics usually occurs within 3-4 weeks.

Treatment for delusional disorders can be done on an outpatient basis or in a hospital setting. In severe cases of delusional disorder, when medical treatment does not help, electroconvulsive therapy can be used by decision of the council of doctors, and with the consent of the patient and his relatives.

Psychotherapy may be used as supportive treatment. Its purpose is to promote adherence to the treatment regimen, as well as to ensure sufficient awareness of the disease. In this case, individual rather than group psychotherapy is recommended, since patients with delusional disorders are often suspicious and sensitive.

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Prevention or advice in case of illness

Prevention of delusional disorder consists in maintaining a healthy psychological environment in the family, dealing with stress, maintaining a healthy lifestyle, as well as seeking medical help in a timely manner if any symptoms of mental disorders occur.

Recommendations for delusional disorder:

Make sure that the patient takes the prescribed medication in a timely manner and visits the attending physician.
If psychotic symptoms worsen, delirium, insomnia, and behavioral disturbances (aggression and irritability), seek medical attention to adjust treatment.
Tune in to positive communication with the patient, be patient, do not argue with him, pretend to agree. Be clear about your thoughts and ask simple questions. Pressure or criticism from others will lead the person to severe stress, which can exacerbate the symptoms of delusional disorders.

References:

Yu. V. Popov, V. D. Vid. Modern clinical psychiatry. - M .: Expert Bureau-M, 1997.
Banshchikov V.M., Korolenko Ts.P., Davydov I.V. General psychopathology. - M .: Moscow Medical Institute. THEM. Sechenov, 1971.
McWilliams, Nancy. Paranoid Personalities // Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process = Psychoanalyticdiagnosis: Understandingpersonalitystructureintheclinicalprocess. - M .: Class, 1998.

Crazy ideas (strange judgments, delirium)

Most often they are perceived by close and surrounding people 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.

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.

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.

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.

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.

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.

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”.

And, which has become a classic, delirium 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.

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.

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