What is delusion in psychology

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.

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.

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?

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.

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?

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?

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.

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 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

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.

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.

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.

A note from Cleveland Clinic

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.

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, 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.

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.

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.

Delusions and thoughts and thoughts, psychiatry, obsessive delusional thoughts and their stages

In psychiatry, delusional thoughts are persistent beliefs or conclusions that do not correspond to the surrounding realities and that arise on a painful basis. These thoughts cannot be corrected by telling the patient about the real state of things, they cannot be proved to be absurd.

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In fact, delusional thoughts are nothing but the result of a misinterpretation of the present reality generated by the disease, although these conclusions and conclusions have nothing to do with reality. It is interesting that all attempts to convince the patient do not give a result - he becomes even more confident that he is right.

It is noteworthy that delusional thoughts can be very different, of the most unusual themes and interpretations, however, in most cases, experts observe:

delusions of persecution - such patients believe that someone is following them, that someone wants to kill them, steal them, that only intrigues are woven around and conspiracies are organized. In their delirium, patients often drag in an alien mind, evil spirits, divine entities, special services of various countries;
nonsense impact. Such patients are sure that certain people around them are to blame for all their troubles. So, all events are perceived as the result of someone's evil intentions. In particular, such patients can be quite sure that their thoughts are being read by third parties through invisible beams, lasers, beacons and other equipment. It is these conclusions that make such patients leave their homes and move to other areas, cities and countries. However, oddly enough, delusional beliefs do not go away.

It is also impossible to ignore another, no less common nonsense - invention, reformism, greatness, special attitude. Often there is also delusions of hypochondria, when the patient is sure that he is developing a terrible disease, but at the same time, examinations are not able to detect violations. At an older age, delusions of damage are often encountered, when a person is sure that in his absence, neighbors can ruin some things, put poison in food, rob that his relatives are surviving from housing. Note that even people who are far from medicine and psychiatry can easily recognize delirium, especially if the delirium is ridiculous and is on the verge of fantasy. In particular, if the patient declares with confidence that he has just stepped off the board of an intergalactic starship, or if he is in fact an alien and has arrived from another planet altogether. As a rule, changes are also noticeable in the attitude of the patient to loved ones - he will be haughty, turn to you, keep his distance, refuse help. But only psychiatrists and specialists can recognize more sophisticated delusions. The problem is that such nonsense is more plausible - in particular, the patient can tell that his sister is taking revenge on him for a long-standing offense: he puts laxatives in food, listens to conversations, constantly watches the street in order to seize a favorable moment for revenge. More common is nonsense concerning spouses - it seems to the patient that he is constantly being cheated on, and he even manages to find evidence of this. It is noteworthy that people around in such situations often believe the sick and for a long time remain in the dark about the true state of things. Doctors note that delusional thoughts that carry the idea of sin and self-accusation are especially dangerous. They are often companions of depressive-delusional attacks of schizophrenia. In the same state, murders and suicides are often committed - for example, the father of the family, suffering from such an attack, can kill his family, and then himself, in his thoughts thus relieving everyone from torment, and doing a good deed. A person with delusional thoughts can be identified by the following symptoms:

manifestations of unjustified fear and anxiety, closing doors or curtains, constantly checking to see if anyone is at the door;
constant worries about one's life and the lives of close people, reaching the point of absurdity - in particular, constant checking of body temperature, pressure and other indicators;
isolation or even hostility, lack of social activity;
strange sayings concerning persecution, one's own guilt, greatness;
meaningful statements that can be interpreted in different ways, but which are incomprehensible to others;
hesitation in eating, refusal to eat for fear of poisoning;
constant complaints to law enforcement agencies and other structures, denunciations of relatives and neighbors.

What should I do if someone close to me is delusional?

avoid questions concerning the details and details of strange statements - no need to clarify anything;
avoid arguments with the patient – you won't prove anything to him anyway. The best tactic is to agree with everything he says;
if the patient's behavior is more or less adequate, and he himself suffers from his condition, try to calm him down and send him to specialists as soon as possible. In no case do we recommend self-medication in such situations - you can aggravate the patient's situation and cause him irreparable harm.

Classification of delusions

Thus, the concept of delirium was formulated as early as the beginning of the 20th century - in 1913 by T. Jaspers, who noted that a delusional disorder has a number of its features, but they are superficial and do not reflect the essence of the disorder. Delusion as one of the symptoms of psychosis affects the entire mental state of the individual and in particular affects the affective and emotional-volitional sphere. Bleuler, a researcher of schizophrenia, described that a delusional state can be characterized by one feature - egocentrism. It is interesting that the everyday perception of delirium is somewhat different from the medical one - people often confuse the unconscious state that develops with infectious lesions with delirium, and people are also able to confuse delusional thoughts and hallucinations. In some patients, delirium is expressed in stories about gold treasures, about wealth and other accumulations. And all this is recounted in detail. Other patients imagine that they are charging through the mains, similar to mobile phones and other gadgets. Still others are afraid to drink fresh water, imagining that it is dangerous for their lives. Patients with paraphrenia may say that they have continued to live for millions of years, moreover, they are firmly convinced of their immortality. Often, such patients can tell that they actually came from other planets, that they saw the Senate in Ancient Rome, or that they took part in the military campaigns of the Ottoman troops. They constantly and in colors talk about past historical events, while being in high spirits.

Symptoms of delusional thoughts

So, delusions seriously affect the state of the psyche, often such patients show paralogicality. They are too talkative, they are convinced that they are right, but at the same time they do not notice the obvious inconsistency of their beliefs with the surrounding reality. Interestingly, with all these qualities, such patients retain mental clarity. Specialists should distinguish between the delusions of normal people and the delusions of patients. If the former can be convinced of being wrong by appealing to facts, then healthy criticism will not affect the latter. So, when determining the differential diagnosis, several aspects should be borne in mind:

the presence of pathology – in order for a person to develop a delusional state, a pathological change is necessary, since simple delusions cannot be caused by mental disorders;
if a delusion is caused by an objective circumstance - for example, misinformation from a magazine that a person has read, then delirium is caused regardless of environmental factors;
if a person is mistaken, his opinion can be corrected, while the correction of delirium is simply impossible. The very concept of a delusional idea often contradicts the patient's pre-existing worldview. In practice, differentiation can be difficult.

Features of the acute state of delirium. So, this category includes situations where the patient is completely in the grip of a delusional disorder. In rare cases, patients are able to periodically adequately analyze what is happening, control themselves, but this usually does not apply to the crazy idea itself. So, experts call this state encapsulated.
Features of primary delirium. Such a state is also classified as primordial, verbal or interpretative. At the same time, patients suffer from rational thinking and awareness. It is interesting that, despite such shortcomings, patients are able to remain functional for a sufficiently long period of time.
Features of secondary delusions. Usually such a lesion develops as a result of a violation of perception. At the same time, hallucinations and falling into illusions predominate in patients. Patients indulge in their delusional ideas, but the latter do not differ in the integrity of the picture, they appear in fragments. Thinking is disturbed a second time, the patient interprets his visions and hallucinations in his own way. In this case, the treatment is mainly aimed at eliminating the symptoms and the underlying disease.

Secondary delusional disorder is divided into:

sensory. In this case, the delirium is rich, specific, sudden, emotionally vivid. It is a delusion of perception;
shaped. In this case, the patient has various fantasies and memories that lead to false conclusions and conclusions. In fact, we are talking about a delusion of representation.

What are the stages of delirium?

As a rule, the delusional state manifests itself in different ways at different stages. Let's see how this happens.

The first stage is the delusional stage.
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