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{{DiseaseDisorder infobox |
__NOTOC__
  Name        = Delusional disorder |
{{Delusional disorder}}
  ICD10      = F22 |
  ICD9        = {{ICD9|297.1}} |
}}
{{SI}}
{{CMG}}; {{AE}} {{JH}}


{{SK}} Apparition; false impression; fantasy; head trip; phantasm; phantom
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


==Overview==
{{CMG}}{{AE}}{{Simrat}}
'''Delusional disorder''' is a psychiatric diagnosis denoting a [[psychosis|psychotic]] [[mental illness]] that involves holding one or more non-bizarre [[delusion]]s 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 [[hallucination]]s, 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)
{{SK}} Delusional disorders; DD
==[[Delusional disorder overview|Overview]]==


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.
==[[Delusional disorder historical perspective|Historical Perspective]]==


==Indicators of a delusion==
==[[Delusional disorder classification|Classification]]==
(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==
==[[Delusional disorder pathophysiology|Pathophysiology]]==
(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==
==[[Delusional disorder causes|Causes]]==


* Erotomanic Type (see [[erotomania]]): delusion that another person, usually of higher status, is in love with the individual.
==[[Delusional disorder differential diagnosis|Differentiating Delusional Disorder from Other Diseases]]==
* [[Grandiose Delusion|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.
==[[Delusional disorder epidemiology and demographics|Epidemiology and Demographics]]==


==Differential Diagnosis==
==[[Delusional disorder comorbid conditions|Comorbid Conditions]]==


==Epidemiology and Demographics==
==[[Delusional disorder risk factors|Risk Factors]]==
==[[Delusional disorder screening|Screening]]==
==[[Delusional disorder natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Risk Factors==
==Diagnosis==
[[Delusional disorder diagnostic criteria| Diagnostic Criteria]] | [[Delusional disorder history and symptoms| History and Symptoms]] | [[Delusional disorder physical examination | Physical Examination]] | [[Delusional disorder laboratory findings|Laboratory Findings]] | [[Delusional disorder chest x ray|Chest X Ray]] | [[Delusional disorder CT|CT]] |  [[Delusional disorder MRI|MRI]] | [[Delusional disorder other imaging findings|Other Imaging Findings]] | [[Delusional disorder other diagnostic studies|Other Diagnostic Studies]]


==Natural History, Complications and Prognosis==
==Treatment==
[[Delusional disorder medical therapy|Medical Therapy]] | [[Delusional disorder primary prevention|Primary Prevention]] | [[Delusional disorder secondary prevention|Secondary Prevention]] | [[Delusional disorder cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Delusional disorder future or investigational therapies|Future or Investigational Therapies]]


==Diagnosis Criteria==
==Case Studies==
 
[[Delusional disorder case study one|Case#1]]
==Treatment==
==References==
{{reflist|2}}
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.
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[[Antipsychotic medication]], if the patient will use it, is often ineffective in controling the delusional system.


==See also==
* [[Delusion]]
* [[Monothematic delusions]]
* [[Paranoia]]
* [[Psychosis]]
* [[Schizophrenia]]


==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


[[Category:Psychiatry]]
[[Category:Psychiatry]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]


[[nl:Waanstoornis]]
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Latest revision as of 21:44, 16 December 2015

Delusional disorder Microchapters

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Overview

Historical Perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Synonyms and keywords: Delusional disorders; DD

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Delusional Disorder from Other Diseases

Epidemiology and Demographics

Comorbid Conditions

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1

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