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Mental Health and Delusional Disorder

In this Article

In this Article

In this Article

  • Types of Delusional Disorder
  • What Are the Symptoms of Delusional Disorder?
  • What Causes Delusional Disorder?
  • How Is Delusional Disorder Diagnosed?
  • How Is Delusional Disorder Treated?
  • What Are the Complications of Delusional Disorder?
  • What Is the Outlook for People With Delusional Disorder?
  • Can Delusional Disorder Be Prevented?

Delusional disorder , previously called paranoid disorder, is a type of serious mental illness called a ” psychosis ” in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, unshakable beliefs in something untrue or not based on reality. People with delusional disorder generally experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated. If the delusions could not happen in reality (aliens, television broadcasting your thoughts) then a person might be considered delusional with bizarre-type delusions.

People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. This is unlike people with other psychotic disorders , who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.

Although delusions might be a symptom of more common disorders, such as schizophrenia , delusional disorder itself is rather rare. Delusional disorder most often occurs in middle to late life and is slightly more common in women than in men.

Types of Delusional Disorder

There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:

  • Erotomanic: Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
  • Grandiose: A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
  • Jealous: A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
  • Persecutory: People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
  • Somatic: A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
  • Mixed: People with this type of delusional disorder have two or more of the types of delusions listed above.

Continued

What Are the Symptoms of Delusional Disorder?

The presence of non-bizarre delusions is the most obvious symptom of this disorder. Other symptoms that mighty appear include:

  • An irritable, angry, or low mood
  • Hallucinations (seeing, hearing, or feeling things that are not really there) that are related to the delusion (For example, a person who believes he or she has an odor problem may smell a bad odor.)

What Causes Delusional Disorder?

As with many other psychotic disorders, the exact cause of delusional disorder is not yet known. Researchers are, however, looking at the role of various genetic, biological, environmental or psychological factors.

  • Genetic: 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. It is believed that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their children.
  • Biological: Researchers are studying how abnormalities of certain areas of the brain might be involved in the development of delusional disorders. Abnormalities in the functioning of brain regions that control perception and thinking may be linked to the formation of delusional symptoms.
  • Environmental/psychological: Evidence suggests that delusional disorder can be triggered by stress. Alcohol and drug abuse also might contribute to the condition. People who tend to be isolated, such as immigrants or those with poor sight and hearing, appear to be more vulnerable to developing delusional disorder.

How Is Delusional Disorder Diagnosed?

If symptoms of delusional disorder are present, your doctor will likely perform a complete medical history and physical exam . Although there are no lab tests to specifically diagnose delusional disorder, the doctor might use various diagnostic tests, such as imaging studies or blood tests, to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist , health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. The doctor or therapist bases his or her diagnosis on the person’s report of symptoms, and his or her observation of the person’s attitude and behavior. The doctor or therapist then determines if the person’s symptoms point to a specific disorder. A diagnosis of delusional disorder is made if a person has non-bizarre delusions for at least one month and does not have the characteristic symptoms of other psychotic disorders, such as schizophrenia .

Continued

How Is Delusional Disorder Treated?

Treatment for delusional disorder most often includes medication and psychotherapy (a type of counseling). Delusional disorder can be very difficult to treat in part because its sufferers often have poor insight and do not recognize that a psychiatric problem exists. Studies show that close to half of patients treated with antipsychotic medications show at least partial improvement.

Antipsychotic medicines are the primary treatment for delusional disorder. Sometimes, psychotherapy can also be a helpful adjunct to medications as a way to help patients better manage and cope with the stresses related to their delusional beliefs and its impact on their lives. Psychotherapies that may be helpful in delusional disorder include the following:

  • Individual psychotherapy: Can help the person recognize and correct the underlying thinking that has become distorted.
  • Cognitive-behavioral therapy (CBT): Can help the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings.
  • Family therapy: Can help families deal more effectively with a loved one who has delusional disorder, enabling them to contribute to a better outcome for the person.

The primary medications used to attempt to treat delusional disorder are called anti-psychotics. Drugs used include:

  • Conventional antipsychotics: Also called neuroleptics, these have been used to treat mental disorders since the mid-1950s. They work by blocking dopamine receptors in the brain . Dopamine is a neurotransmitter believed to be involved in the development of delusions. Conventional antipsychotics include chlorpromazine  (Thorazine),  fluphenazine  ( Prolixin ),  haloperidol  ( Haldol ),  loxapine  ( Loxapine ),  perphenazine  (Trilafon), thioridazine (Mellaril), thiothixene  (Navane), and trifluoperazine  (Stelazine).
  • Atypical antipsychotics: These newer drugs appear to be effective in treating the symptoms of delusional disorder with fewer movement-related side effects than the older typical antipsychotics. They work by blocking dopamine and serotonin receptors in the brain . Serotonin is another neurotransmitter believed to be involved in delusional disorder. These drugs include ari piprazole (Abilify), aripiprazole lauroxil (Aristada), asenapine ( Saphris ), clozapine  ( Clozaril ), iloperidone ( Fanapt ), lurasidone ( Latuda ), paliperidone  ( Invega  Sustenna), paliperidone  palmitate  (Invega Trinza), quetiapine  ( Seroquel ), risperidone  ( Risperdal ), olanzapine ( Zyprexa ), and ziprasidone  ( Geodon ) 
  • Newer
    atypical antipsychotics: these include brexpiprazole (Rexulti) and cariprazine (Vraylar).
  • Other medications:
    S edatives and antidepressants might also be used to treat anxiety or mood symptoms if they occur in combination with delusional disorder. Tranquilizers might be used if the person has a very high level of anxiety or problems sleeping. Antidepressants might be used to treat depression , which often occurs in people with delusional disorder

People with severe symptoms or who are at risk of hurting themselves or others might need to be hospitalized until the condition is stabilized.

 

Continued

What Are the Complications of Delusional Disorder?

  • People with delusional disorder might become depressed , often as the result of difficulties associated with the delusions.
  • Acting on the delusions also can lead to violence or legal problems; for example, a person with an erotomanic delusion who stalks or harasses the object of his or her delusion, could lead to arrest.
  • Further, people with this disorder can eventually become alienated from others, especially if their delusions interfere with or damage their relationships .

What Is the Outlook for People With Delusional Disorder?

The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person’s life circumstances, including the availability of support and a willingness to stick with treatment.

Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms).

Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.

Can Delusional Disorder Be Prevented?

There is 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.

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Delusional disorder

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Delusional disorder
SynonymsParanoid disorder
Specialty Psychiatry , Psychotherapy   Edit this on Wikidata
SymptomsStrong false beliefs despite superior evidence to the contrary
TypesErotomanic type, grandiose type, jealous type, persecutory type, somatic type, mixed type, unspecified type
Differential diagnosis Paranoid personality disorder , schizophrenia , bipolar disorder , substance-induced psychosis

Delusional disorder is a generally rare mental illness in which the patient presents delusions , but with no accompanying prominent hallucinations , thought disorder, mood disorder , or significant flattening of affect . [1] [2] Delusions are a specific symptom of psychosis . Delusions can be “bizarre” or “non-bizarre” in content; [2] non-bizarre delusions are fixed false beliefs that involve situations that could potentially occur in real life, such as being harmed or poisoned. [3] Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not necessarily generally seem odd. [4] However, the preoccupation with delusional ideas can be disruptive to their overall lives. [4]

For the diagnosis to be made, auditory and visual hallucinations cannot be prominent, though olfactory or tactile hallucinations related to the content of the delusion may be present. [2] The delusions cannot be due to the effects of a drug , medication , or general medical condition , and delusional disorder cannot be diagnosed in an individual previously properly diagnosed with schizophrenia . A person with delusional disorder may be high functioning in daily life. Recent and comprehensive metaanalyses of scientific studies point to an association between a deterioration in aspects of IQ in psychotic patients, in particular perceptual reasoning. [5] [6] [7]

According to German psychiatrist Emil Kraepelin , patients with delusional disorder remain coherent, sensible and reasonable. [8] [ dubious – discuss ] The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines six subtypes of the disorder characterized as erotomanic (believes that someone is in love with them), grandiose (believes that they are the greatest, strongest, fastest, richest, or most intelligent person ever), jealous (believes that the love partner is cheating on them), persecutory (delusions that the person or someone to whom the person is close is being malevolently treated in some way), somatic (believes that they have a disease or medical condition), and mixed, i.e., having features of more than one subtype. [2] Delusions also occur as symptoms of many other mental disorders, especially the other psychotic disorders .

The DSM-IV, and psychologists agree that personal beliefs should be evaluated with great respect to cultural and religious differences, since some cultures have widely accepted beliefs that may be considered delusional in other cultures. [9]

Contents

  • 1 Classification
  • 2 Signs and symptoms
  • 3 Gaslighting
  • 4 Criticism
  • 5 Causes
  • 6 Diagnosis
  • 7 Treatment
  • 8 Epidemiology
  • 9 In popular culture
  • 10 See also
  • 11 References
  • 12 Further reading
  • 13 External links

Classification[ edit ]

Diagnosis of a specific type of delusional disorder can sometimes be made based on the content of the delusions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) enumerates seven types:

  • Erotomanic type (erotomania) : delusion that another person, often a prominent figure, is in love with the individual. The individual may breach the law as he/she tries to obsessively make contact with the desired person.
  • Grandiose type (megalomania) : delusion of inflated worth, power, knowledge, identity or believes themself to be a famous person, claiming the actual person is an impostor or an impersonator.
  • Jealous type : delusion that the individual’s sexual partner is unfaithful when it is untrue. The patient may follow the partner, check text messages, emails, phone calls etc. in an attempt to find “evidence” of the infidelity.
  • Persecutory type : This delusion is a common subtype. It includes the belief that the person (or someone to whom the person is close) is being malevolently treated in some way. The patient may believe that he/she has been drugged, spied upon, harmed, harassed and so on and may seek “justice” by making reports, taking action or even acting violently.
  • Somatic type : delusions that the person has some physical defect or general medical condition
  • Mixed type: delusions with characteristics of more than one of the above types but with no one theme predominating.
  • Unspecified type: delusions that cannot be clearly determined or characterized in any of the categories in the specific types. [10]

Signs and symptoms[ edit ]

The following can indicate a delusion: [11]

  1. The patient expresses an idea or belief with unusual persistence or force, even when evidence suggests the contradictory.
  2. That idea appears to have an undue influence on the patient’s life, and the way of life is often altered to an inexplicable extent.
  3. Despite their profound conviction, there is often a quality of secretiveness or suspicion when the patient is questioned about it.
  4. The individual tends to be humorless and oversensitive, especially about the belief.
  5. There is a quality of centrality: no matter how unlikely it is that these strange things are happening to them, the patient accepts them relatively unquestioningly.
  6. An attempt to contradict the belief is likely to arouse an inappropriately strong emotional reaction, often with irritability and hostility. They will not accept any other opinions.
  7. The belief is, at the least, unlikely, and out of keeping with the patient’s social, cultural, and religious background.
  8. The patient is emotionally over-invested in the idea and it overwhelms other elements of their psyche .
  9. The delusion, if acted out, often leads to behaviors which are abnormal and/or out of character, although perhaps understandable in light of the delusional beliefs.
  10. Individuals who know the patient observe that the belief and behavior are uncharacteristic and alien.

Additional features of delusional disorder include the following: [11]

  1. It is a primary disorder.
  2. It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.
  3. The illness is chronic and frequently lifelong.
  4. The delusions are logically constructed and internally consistent.
  5. The delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is usually no general disturbance of behavior. If disturbed behavior does occur, it is directly related to the delusional beliefs.
  6. The individual experiences a heightened sense of self-reference. Events which, to others, are nonsignificant are of enormous significance to him or her, and the atmosphere surrounding the delusions is highly charged.

However this should not be confused with gaslighting, where a person denies the truth, and causes the victim to think that they are being delusional.

Gaslighting[ edit ]

Sometimes a correct belief may be mistaken for a delusion, such as when the belief in question is not demonstrably false but is nevertheless considered beyond the realm of possibility. A specific variant of this is when a person is fed lies in an attempt to convince them that they are delusional, a process called ” gaslighting ,” after the 1938 play Gas Light , the plot of which centered around the process.

Gaslighting is frequently used by people with antisocial personality disorder or narcissistic personality disorder. Sometimes, gaslighting can be unintentional, for example if a person, or a group of people aim to lie or cover up an issue, it can lead to the victim being gaslighted as well. [12]

Criticism[ edit ]

In other situations the delusion may turn out to be true belief. [13] For example, in delusional jealousy , where a person believes that their partner is being unfaithful (and may even follow them into the bathroom believing them to be seeing their lover even during the briefest of partings), it may actually be true that the partner is having sexual relations with another person. In this case, the delusion does not cease to be a delusion because the content later turns out to be verified as true or the partner actually chose to engage in the behavior of which they were being accused.

In other cases, the delusion may be mistakenly assumed to be false by a doctor or psychiatrist assessing the belief, just because it seems to be unlikely, bizarre or held with excessive conviction. Psychiatrists rarely have the time or resources to check the validity of a person’s claims leading to some true beliefs to be erroneously classified as delusional. [14] This is known as the Martha Mitchell effect , after the wife of the attorney general who alleged that illegal activity was taking place in the White House . At the time, her claims were thought to be signs of mental illness, and only after the Watergate scandal broke was she proved right (and hence sane).

Similar factors have led to criticisms of Jaspers’ definition of true delusions as being ultimately ‘un-understandable’. Critics (such as R. D. Laing ) have argued that this leads to the diagnosis of delusions being based on the subjective understanding of a particular psychiatrist, who may not have access to all the information that might make a belief otherwise interpretable.

Another difficulty with the diagnosis of delusions is that almost all of these features can be found in “normal” beliefs. Many religious beliefs hold exactly the same features, yet are not universally considered delusional. For instance, if a person was holding a true belief then they will of course persist with it. This can cause the disorder to be misdiagnosed by psychiatrists. These factors have led the psychiatrist Anthony David to note that “there is no acceptable (rather than accepted) definition of a delusion.” [15]

Causes[ edit ]

The cause of delusional disorder is unknown, [3] but genetic , biochemical , and environmental factors may play a significant role in its development. [16] [ better source needed ] Some people with delusional disorders may have an imbalance in neurotransmitters , the chemicals that send and receive messages to the brain. [17] There does seem to be some familial component, and immigration (generally for persecutory reasons), [3] drug abuse, excessive stress, [18] being married, being employed, low socioeconomic status , celibacy among men, and widowhood among women may also be risk factors. [19] Delusional disorder is currently thought to be on the same spectrum or dimension as schizophrenia , but people with delusional disorder, in general, may have less symptomatology and functional disability. [20]

Diagnosis[ edit ]

Differential diagnosis includes ruling out other causes such as drug-induced conditions, dementia , infections , metabolic disorders , and endocrine disorders . [3] Other psychiatric disorders must then be ruled out. In delusional disorder, mood symptoms tend to be brief or absent, and unlike schizophrenia , delusions are non-bizarre and hallucinations are minimal or absent. [3]

Interviews are important tools to obtain information about the patient’s life situation and past history to help make a diagnosis. Clinicians generally review earlier medical records to gather a full history. Clinicians also try to interview the patient’s immediate family , as this can be helpful in determining the presence of delusions. The mental status examination is used to assess the patient’s current mental condition. [21]

A psychological questionnaire used in the diagnosis of the delusional disorder is the Peters Delusion Inventory (PDI) which focuses on identifying and understanding delusional thinking. However, this questionnaire is more likely used in research than in clinical practice. [21]

In terms of diagnosing a non-bizarre delusion as a delusion, ample support should be provided through fact checking. In case of non-bizarre delusions, Psych Central [22] notes, “All of these situations could be true or possible, but the person suffering from this disorder knows them not to be (e.g., through fact-checking, third-person confirmation, etc.).”

Treatment[ edit ]

A challenge in the treatment of delusional disorders is that most patients have limited insight, and do not acknowledge that there is a problem. [3] Most patients are treated as out-patients, although hospitalization may be required in some cases if there is a risk of harm to self or others. [3] Individual psychotherapy is recommended rather than group psychotherapy , as patients are often quite suspicious and sensitive. [3] Antipsychotics are not well tested in delusional disorder, but they do not seem to work very well, and often have no effect on the core delusional belief. [3] Antipsychotics may be more useful in managing agitation that can accompany delusional disorder. [3] Until further evidence is found, it seems reasonable to offer treatments which have efficacy in other psychotic disorders. [23]

Psychotherapy for patients with delusional disorder can include cognitive therapy which is conducted with the use of empathy . During the process, the therapist can ask hypothetical questions in a form of therapeutic Socratic questioning . [24] This therapy has been mostly studied in patients with the persecutory type. The combination of pharmacotherapy with cognitive therapy integrates treating the possible underlying biological problems and decreasing the symptoms with psychotherapy as well. Psychotherapy has been said to be the most useful form of treatment because of the trust formed in a patient and therapist relationship. [25]

Supportive therapy has also been shown to be helpful. Its goal is to facilitate treatment adherence and provide education about the illness and its treatment.

Furthermore, providing social skills training has helped many persons. It can promote interpersonal competence as well as confidence and comfort when interacting with those individuals perceived as a threat . [26]

Insight-oriented therapy is rarely indicated or contraindicated; yet there are reports of successful treatment. [26] Its goals are to develop therapeutic alliance, containment of projected feelings of hatred , impotence , and badness; measured interpretation as well as the development of a sense of creative doubt in the internal perception of the world. The latter requires empathy with the patient’s defensive position. [26]

Epidemiology[ edit ]

Delusional disorders are uncommon in psychiatric practice, though this may be an underestimation due to the fact that those afflicted lack insight and thus avoid psychiatric assessment. The prevalence of this condition stands at about 24 to 30 cases per 100,000 people while 0.7 to 3.0 new cases per 100,000 people are reported every year. Delusional disorder accounts for 1–2% of admissions to inpatient mental health facilities. [2] [27] The incidence of first admissions for delusional disorder is lower, from 0.001–0.003%. [28]

Delusional disorder tends to appear in middle to late adult life, and for the most part first admissions to hospital for delusional disorder occur between age 33 and 55. [3] It is more common in women than men, and immigrants seem to be at higher risk. [3]

In popular culture[ edit ]

In the 2010 psychological thriller Shutter Island , directed by Martin Scorsese and starring Leonardo DiCaprio , delusional disorder is portrayed along with other disorders. [29] [30] An Indian movie ” Anantaram (Thereafter)” directed by Adoor Gopalakrishnan also portrays the complex nature of delusions. [31] [32]

See also[ edit ]

  • Delusional parasitosis
  • Monothematic delusions
  • Morgellons
  • Paranoia
  • Shared delusional disorder

References[ edit ]

  1. ^ Semple.David.”Oxford Hand Book of Psychiatry” Oxford Press. 2005. p 230
  2. ^ a b c d e American Psychiatric Association . (2013). Diagnostic and Statistical Manual of Mental Disorders , (5th ed., text revision). Washington, DC: American Psychiatric Association.
  3. ^ a b c d e f g h i j k l Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, DC: American Psychiatric Publishing, Inc., 2003
  4. ^ a b Winokur, George.”Comprehensive Psychiatry-Delusional Disorder”American Psychiatric Association. 1977. p 513
  5. ^ https://www.researchgate.net/publication/11315979_Perceptual_organization_deficits_in_psychotic_patients
  6. ^ http://bjp.rcpsych.org/content/195/6/475.long
  7. ^ http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2009.09010118
  8. ^ Winokur, G (1977). “Delusional Disorder (Paranoia)”. Comprehensive Psychiatry. 18 (6): 511–521. doi : 10.1016/s0010-440x(97)90001-8 .

  9. ^ Shivani Chopra. “Delusional Disorder” . eMedicine.
  10. ^ http://www.health.am/psy/delusional-disorder Delusional Disorder. Retrieved 7 August 2012
  11. ^ a b Munro, Alistair (1999). Delusional disorder: paranoia and related illnesses. Cambridge, UK: Cambridge University Press. ISBN   0-521-58180-X .
  12. ^ The Sociopath Next Door by Martha Stout (2006) Harmony. ISBN   0767915828 .
  13. ^ Jones E (1999). “The phenomenology of abnormal belief” . Philosophy, Psychiatry and Psychology. 6: 1–16.
  14. ^ Maher B.A. (1988). “Anomalous experience and delusional thinking: The logic of explanations”. In Oltmanns T.; Maher B. Delusional Beliefs. New York: Wiley Interscience. ISBN   0-471-83635-4 .
  15. ^ David AS (1999). “On the impossibility of defining delusions”. Philosophy, Psychiatry and Psychology. 6 (1): 17–20.
  16. ^ “Causes of Delusional Disorder” . Retrieved 2010-08-06.
  17. ^ Kay DWK. “Assessment of familial risks in the functional psychoses and their application in genetic counseling. Br J Pschychiatry.” 1978. p385-390
  18. ^ Karakus, Gonca.”Delusional Parasitosis: Clinical Features, Diagnosis and Treatment”American Psychiatric Association. 2010.p396
  19. ^ Shivani Chopra, MD; Chief Editor; et al. “Delusional Disorder – Epidemiology – Patient demographics” . Retrieved 2013-04-15.CS1 maint: Multiple names: authors list ( link ) CS1 maint: Extra text: authors list ( link )
  20. ^ Stephan Heckers, Deanna M. Barch, Juan Bustillo, Wolfgang Gaebel, Raquel Gur, Dolores Malaspina, Michael J. Owen, Susan Schultz, Rajiv Tandon, Ming Tsuang, Jim Van Os, William T. Carpenter . Structure of the psychotic disorders classification in DSM 5. Schizophrenia Research. 2013. doi : 10.1016/j.schres.2013.04.039 . PMID   23707641 .
  21. ^ a b “Delusional Disorders:Treatment” . Retrieved 2010-08-06.
  22. ^ “Delusional Disorder Symptoms” . Retrieved 2015-03-04.
  23. ^ Skelton M, Khokhar W, Thacker SP Cochrane review 22nd May 2015.
  24. ^ “Treatments” . Retrieved 2010-08-06.
  25. ^ Grohol, John. “Delusional Disorder Treatment” . Psych Central. Retrieved 24 November 2011.
  26. ^ a b c Shivani Chopra, MD; Chief Editor. “Delusional Disorder – Treatment & Management – Psychotherapy” . Medscape reference. Retrieved 2013-04-15.CS1 maint: Multiple names: authors list ( link ) CS1 maint: Extra text: authors list ( link )
  27. ^ Crowe, R. R., & Roy, M. A. (2008). Delusional disorders. In S. H. Fatemi & P. J. Clayton (Eds.), The Medical Basis of Psychiatry (pp. 125-131). New York, USA: Humana Press.
  28. ^ “Demography of paranoid psychosis (delusional disorder): a review and comparison with schizophrenia and affective illness”. Arch Gen Psychiatry. 39 (8): 890–902. Aug 1982. doi : 10.1001/archpsyc.1982.04290080012003 . PMID   7103678 .
  29. ^ “Archived copy” . Archived from the original on 2015-04-02. Retrieved 2015-03-28.CS1 maint: Archived copy as title ( link )
  30. ^ http://steinhardt.nyu.edu/opus/issues/2010/spring/shutter_island
  31. ^ Mammootty, Adoor; Asokan; Shobana; Bahadur (1987-10-01), Anantaram , retrieved 2017-02-02
  32. ^ “Anantaram: After three years, another landmark from Adoor Gopalakrishnan” . Retrieved 2017-02-02.

Further reading[ edit ]

  • Arnold, K.; Vakhrusheva, J. (2015). “Resist the negation reflex: Minimizing reactance in psychotherapy of delusions” (PDF). Psychosis: 1–10. doi : 10.1080/17522439.2015.1095229 .
  • McDermott, Sarah (22 February 2018), ” ‘The story of a weird world I was warned never to tell’ “, BBC News . [A related case study.]
  • Munro, A. (1999) Delusional Disorder: Paranoia and Related Illnesses. Cambridge: Cambridge University Press. ISBN   0-521-58180-X .
  • Sims, A. (1995) Symptoms in the mind: An introduction to descriptive psychopathology. Edinburgh: Elsevier Science Ltd. ISBN   0-7020-2627-1 .

External links[ edit ]

Classification
D
  • ICD – 10 : F22.0
  • ICD – 9-CM : 297.1
  • MeSH : D010259
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Retrieved from ” https://en.wikipedia.org/w/index.php?title=Delusional_disorder&oldid=867067462 ”
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      • Persecutory delusional disorder

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      Dpd

      Dpd

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      ‎19-10-2016

      11:28 PM

      ‎19-10-2016

      11:28 PM

      ‎19-10-2016

      11:28 PM

      ‎19-10-2016

      11:28 PM

      Persecutory delusional disorder


      My mum has been diagnosed with persecutory delusional disorder. She has no insight whatsoever and has had delusional thoughts for some time, and prior to that suffered from OCD (hoarding, anxiety).

      She believes my father and I employ people to poison her, stab her, vandalise her possessions, steal from her and track her through her mobile etc.

      She has lost her job, refuses to drive her car, and is effectively homeless. She is also spending money at a rate she cannot sustain i.e. Living in hotel rooms and employing security guards.

      I am finding it almost impossible to get her the help she needs, despite the sympathetic help of mental health services.

      She was involuntarily committed for a week recently when she approached the emergency section of a hospital claiming she’d been poisoned. This resulted in her diagnosis. She is much worse since being discharged and the hospital believes she needs to be reassessed.


      Aside from my father, who is estranged from mum, I am her only relative in Australia so I cannot be implicated in getting her sectioned as I need to help with any recovery. Because she has no fixed abode it is difficult to know where she is to alert the mental health services. She is also totally ‘with it’ and would easily talk her way out of a police welfare check or even a mental health check not undertaken by the hospital psychiatrist who knows her…yet the hospital cannot attend a hotel without the police, but the only times we know she is at the hotel it is not possible to coordinate police and hospital to attend together!

      Meanwhile she is ruining herself financially…

      If anyone has advice on:

      1. How to get her sectioned, and/or
      2. How to secure her finances through the public trustee (without me being implicated)

      Thanks




      2


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      6 REPLIES

      in response to: Persecutory delusional disorder

      marchhare

      Moderator

      marchhare

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      ‎20-10-2016

      12:05 AM

      ‎20-10-2016

      12:05 AM

      ‎20-10-2016

      12:05 AM

      ‎20-10-2016

      12:05 AM

      Re: Persecutory delusional disorder


      Hi Dpd,


      it isi Marchhare here. One of the forum moderators.


      Welcome to the SANE forums. It sounds as if your Mother is having a lot of delusional mental problems and it also sounds as if you are alone in helping her. Hopefully there are members here who can give you advice and direction on where to go from here.


      Marchhare

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      in response to: Persecutory delusional disorder

      Former-Member

      Not applicable
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      ‎20-10-2016

      03:56 AM

      ‎20-10-2016

      03:56 AM

      ‎20-10-2016

      03:56 AM

      ‎20-10-2016

      03:56 AM

      Re: Persecutory delusional disorder



      Hi @Dpd , welcome to the forums. Sounds lime you really care about your mum yet frustrated by feeling so powerless. This must be so painful for you with your parents estranged as well.

      I have 2 brothers with paranoid psychosis and understand the conflict between wanting to dob them in yet maintaining their trust. I was about to print up and mail my bro’s Tx msgs to MH but was relieved when he himself put it all in Stat Dec to the police who activated MH to have him Assessed for 7 days. He’s back on antipsychotic tablets again, but we shall see how long it lasts because he’s being discharged tomorrow apparently.

      Its very hard because they think we’re part of the conspiracy (delusion) just for not believing them and getting onboard (as if!)

      If your mum is hospitalised again, alert the Mental Health Team to her spending & homelessness. The team have the power and processes to activate Trustee to supervise spending.

      Please be careful to look after your own needs too. These things have a way of working themselves out. Talk to her, try to reason, get her into counselling with a psychologist etc, because you care, but it really is her call and sometimes they have to fall hard to learn. So try pull back emotionally, guard your heart.
      Cheers

      1


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      in response to: Re: Persecutory delusional disorder

      CherryBomb

      CherryBomb

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      ‎21-10-2016

      08:09 PM

      ‎21-10-2016

      08:09 PM

      ‎21-10-2016

      08:09 PM

      ‎21-10-2016

      08:09 PM

      Re: Persecutory delusional disorder


      Hi  @Dpd ,


      It sounds very stressful, and like you’re dealing with on your own. 


      @Former-Member  has provided some really useful advice. I agree, it is extremely tough getting help for someone, particularly when they lack insight into their own condition and they are not will to reach out for help. Keep the communication lines clear with your mum, and look after yourself too. There is only so much you can do.


      You mentioned that you’ve been talking to MH services. Have you had an opportunity to speak with your mum’s treating team? 

      1


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      in response to: Re: Persecutory delusional disorder

      ivana

      ivana

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      ‎21-10-2016

      11:39 PM

      ‎21-10-2016

      11:39 PM

      ‎21-10-2016

      11:39 PM

      ‎21-10-2016

      11:39 PM

      Re: Persecutory delusional disorder


      Hi DpD,

      How old is your mum if you don’t mind the question?

      Have you considered the possibility of Dementia or something else that’s fits outside of the DSM diagnostic model?

      Often doctors will neglect to consider this if the patients primary symptoms are Psychiatric in nature.

      1


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      in response to: Persecutory delusional disorder

      Hourglass

      Hourglass

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      ‎01-11-2018

      12:28 PM

      ‎01-11-2018

      12:28 PM

      ‎01-11-2018

      12:28 PM

      ‎01-11-2018

      12:28 PM

      Re: Persecutory delusional disorder


      I have this disorder myself.  It is impossible to believe anything other than the delusion.  The hospital psychiatrist could help with all legalities 

      1


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      in response to: Persecutory delusional disorder

      GTM

      GTM

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      ‎28-11-2018

      01:51 AM

      ‎28-11-2018

      01:51 AM

      ‎28-11-2018

      01:51 AM

      ‎28-11-2018

      01:51 AM

      Re: Persecutory delusional disorder


      Hi Dpd, my mother has also been diagnosed with Persecutory Deusional disorder, she also lacks insight and is in constant belief of me and my two siblings being in danger from bad people. She also believes she is being spied on by the government and that she is agent of some kind. Our Father is also estranged from our mother due to abuse from my mother (caused by her disorder)

       

      I am thankful that I have my two siblings to help deal with it. And we also live in Australia. She also like your mother, was spending money unsustainably. We contacted MH and got her assessed and they placed her on involuntary injections which really really helped. However they removed her from the injections because she had gotten better. We are currently going through MH again to get her back on the injections. It is a battle that doesn’t stop, and I hope your mother got the help that she required. 

      1


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