Delusional Disorder

Delusional disorder is characterized by having continuous delusions where the person cannot tell what is real versus what is just part of their self-assumed delusion/fantasy. Delusions may also occur with other types of mental health issues such as paranoid delusion, schizophrenia, bipolar disorder, and certain personality disorders. 

Overview

Delusions are persistent beliefs in something that is not real or factual, but they are also not completely unrealistic. Delusional Disorder involves delusions that are not necessarily bizarre delusional or strange and usually include false perceptions or practices. However, in reality, these beliefs are either not true or are highly overstated. Conversely, a bizarre delusion is something that could never take place in real life such as flying high in the sky without being in an airplane or traveling to Mars, etc.

People with Delusional Disorder can usually continue to connect with people and function normally. They do not behave in an odd or disturbing manner but in some circumstances, they may become so entrenched with their delusions that their lives are disturbed. Delusional Disorder itself is not as common as seeing it occur because of psychological disorders. Delusional Disorder often occurs during middle age to late in life and is more common in women than men.

Girl is depressed with Delusional Disorder

Symptoms of Delusional Disorder

  • Non-bizarre delusions which are the most evident symptoms
  • Being short-tempered
  • Aggression
  • Poor mood
  • Hallucinations such as feeling, hearing or seeing things that are not real

Causes and Risk Factors of Delusional Disorder:

The causes of Delusional Disorders are unknown but there is a role of genetics, environmental, or psychological factors that make them t more likely to occur.

Genetic factors

Like with some mental health disorders, there is a thought that a person is predisposed to having a Delusional Disorder which would have been passed on to the individual from their parents. When parts of the brain that regulate perception and thought patterns do not function properly, it can cause symptoms of a Delusional Disorder. 

Environmental/psychological factors

Studies support that stress can give rise to the symptoms of Delusional Disorder. Intake of alcohol and illicit drugs may also add to it. People who are alone are more at risk to develop a Delusional Disorder. 

Types of Delusions with Delusional Disorders

There are 6 Different types of Delusional Disorders like Erotomanic Delusional Disorder, Grandiose Delusional Disorder, Jealous Delusional Disorder, Persecutory Delusional Disorder, Somatic Delusional Disorder, and Mixed Delusional Disorder. Details are mentioned below.

  • Erotomanic Delusions: The person believes that someone is in love with him, and he may try to connect with that person. Usually, Erotomanic Delusional Disorder centers around a famous personality. It may lead to stalking behaviors.
  • Grandiose Delusions: This is a magnified sense of self-obsession, supremacy, acquaintance, or personality delusion. The person in Grandiose Delusional Disorder believes that he is exceptional and that he has a significant influence.
  • Jealous Delusions: The person thinks that his partner is disloyal and, the person may believe that a particular person has better attributes. This is the Delusional disorder jealous type in the list of delusional disorders.
  • Persecutory Delusions: The person in Persecutory Delusional Disorder leads its victim to believe that they are not being treated well by others or that someone is out to harm them in any way. 
  • Somatic Delusions: Somatic Delusional Disorders are focused on perceived physical impairments or medical issues.
  • Mixed Delusions: Persons with Mixed Delusional Disorders have two or more of the types of delusions listed above.

Common Complications of Delusional Disorder:

Individuals that suffer from Delusional Disorder may develop depression because of the consequences that occur related to their delusions. Reacting to the delusions also can evoke feelings of fear or they can lead to legal problems. For example, an individual with erotomanic delusions stalks or bothers the object of their delusion and their actions (e.g., stalking) can lead to an arrest. The individual can also be socially isolated and especially if their delusions interfere or harm their relations with others.

Diagnosis of Delusional Disorder:

There currently is no lab or medical tests available to determine a diagnosis of Delusional Disorder. If medical tests are done, it is to rule out any physical cause for the symptoms of Delusional Disorder. These include:

  • Obsessive-compulsive disorder
  • Epilepsy
  • Alzheimer’s disease
  • Hallucination
  • Delirium
  • Schizophrenia or other mental health problems

If medical reasons for the symptoms are ruled out, the individual may be referred to a psychiatrist to collaborate on the diagnosis and for potential psychotropic medications.                                                                                         

To meet the diagnostic criteria for Delusional Disorder the person must have one or more delusions that last for one month or longer. The delusions have to affect the person’s life. The presence of mania or major depression should not accompany the delusions, and another mental health issue, medical condition. or medications are not suspected as the causative factors for symptoms. 

Treatment of Delusional Disorder

Psychotherapy and medications together can help manage Delusional Disorder. The therapeutic approaches best used are: 

  • Individual psychotherapy helps the individual to identify and correct thinking patterns.
  • Cognitive-behavioral therapy helps to recognize and transform the thoughts and behaviors that lead to delusions.
  • Family therapy helps families to deal with the loved one that has Delusional Disorder. 

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Medications: Usually an antipsychotic will be prescribed such as: :

    • Conventional antipsychotics work by blocking dopamine receptors in the brain, which are involved in the development of delusions. Conventional antipsychotics include Fluphenazine (Prolixin) and Loxapine (Oxilapine) etc.
    • Atypical antipsychotics work by blocking dopamine and serotonin receptors in the brain which are both somewhat involved in causing delusional disorder. These drugs include Clozapine (Clozaril) and Iloperidone (Fanapt) etc.
    • Other medicines: Anti-depressants, sedatives, tranquilizers, and anti-anxiety drugs might help with depression, anxiety, or mood swings