Delusional disorder
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Delusional disorder Classification and external resources | |
| ICD-10 | F22 |
|---|---|
| ICD-9 | 297.1 |
Delusional disorder is a psychiatric diagnosis denoting a psychotic mental illness that involves holding one or more non-bizarre delusions in the absence of any other significant psychopathology (signs or symptoms of mental illness). In particular, a person with delusional disorder has never met any other criteria for schizophrenia and does not have any marked hallucinations, although tactile (touch) or olfactory (smell) hallucinations may be present if they are related to the theme of the delusion. Symptoms last at least one month (pg 329: DSM IV-TR, APA 2000) and should pass with group therapy and guidance from a family member or a friend. Someone who suffers momentarily does not hear or see things that are not there but believes in his or her mind that they are invincible or have a defeatus attitude syndrome.
A person with delusional disorder can be quite functional and does not tend to show any odd or bizarre behavior except as a direct result of the delusional belief. "Despite the encapsulation of the delusional system and the realtive sparing of the personality, the patient's way of life is likely to become more and more overwhelmed by the dominating effect of the abnormal beliefs". (Munro, 1999)
It is worth noting that the term paranoia was previously used in psychiatry to denote what is now called 'delusional disorder'. The modern psychiatric use of the word paranoia is subtly different but now rarely refers to this specific diagnosis.
Indicators of a delusion
(Munro, 1999)
- The patient expresses an idea or belief with unusual persistence or force.
- That idea appears to exert an undue influence on his or her life, and the way of life is often altered to an inexplicable extent.
- Despite his profound conviction, there is often a quality of secretiveness or suspicion when the patient is questioned about it.
- The individual tends to be humorless and oversensitive, especially about the belief.
- There is a quality of centrality: no matter how unlikely it is that these strange things are happening to him, the patient accepts them relatively unquestioningly.
- An attempt to contradict the belief is likely to arouse an inappropriately strong emotional reaction, often with irritability and hostility.
- The belief is, at the least, unlikely.
- The patient is emotionally over-invested in the idea and it overwhelms other elements of his psyche (psychology).
- The delusion, if acted out, often leads to behaviors which are abnormal and/or out of character, although perhaps understandable in the light of the delusional beliefs.
- Individuals who know the patient will observe that his belief and behavior are uncharacteristic and alien.
Features
(Munro, 1999)
- It is a primary disorder.
- It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.
- The illness is chronic and frequently lifelong.
- The delusions are logically constructed and internally consistent.
- 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.
- The individual experiences a heightened sense of self-reference. Events which, to others, are insignificant are of enormous significance to him or her, and the atmosphere surrounding the delusions is highly charged.
Types
- Erotomanic Type (see erotomania): delusion that another person, usually of higher status, is in love with the individual.
- Grandiose Type: delusion of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person (e.g. see Jerusalem syndrome)
- Jealous Type: delusion that the individual's sexual partner is unfaithful (see delusional jealousy).
- Persecutory Type: delusion that the person (or someone to whom the person is close) is being malevolently treated in some way.
- Somatic Type: delusions that the person has some physical defect or general medical condition (for example, see delusional parasitosis).
A diagnosis of 'mixed type' or 'unspecified type' may also be given if the delusions fall into several or none of these categories.
Treatment
Getting a patient to seek a mental health professional and getting them to accept treatment is an extremely diificult process. There is no effective insight and because the delusion is held with extrordinary conviction, any attempt at contradiction is met with anger and disdain.
Antipsychotic medication, if the patient will use it, is often ineffective in controling the delusional system.
See also
Further reading
- Munro, A. (1999) Delusional disorder. 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
- APA.(2000) "Diagnostic and Statistical Manual, Fourth Edition, Text Revision". Washington DC: American Psychiatric Association. ISBN 978-0890420249
External links
nl:WaanstoornisAcknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
