A delusion is an unshakable belief in something untrue. These irrational beliefs defy normal reasoning, and remain firm even when overwhelming proof is presented to dispute them. Delusions are often accompanied by hallucinations
and/or feelings of paranoia
, which act to strengthen confidence in the delusion. Delusions are distinct from culturally or religiously based beliefs that may be seen as untrue by outsiders.
Delusions are a common symptom of several mood and personality-related mental illnesses, including schizoaffective disorder
, schizophrenia, shared psychotic disorder, major depressive disorder, and bipolar disorder
. They are also the major feature of delusional disorder. Individuals with delusional disorder suffer from long-term, complex delusions that fall into one of six categories: persecutory, grandiose, jealousy, erotomanic, somatic, or mixed. There are also delusional disorders such as dementia
that clearly have organic or physical causes.
Individuals with persecutory delusional disorder are plagued by feelings of paranoia and an irrational yet unshakable belief that someone is plotting against them, or out to harm them.
Individuals with grandiose delusional disorder have an inflated sense of self-worth. Their delusions center on their own importance, such as believing that they have done or created something of extreme value or have a "special mission."
Jealous delusions are unjustified and irrational beliefs that an individual's spouse or significant other has been unfaithful.
Individuals with erotomanic delusional disorder believe that another person, often a stranger, is in love with them. The object of their affection is typically of a higher social status, sometimes a celebrity. This type of delusional disorder may lead to stalking or other potentially dangerous behavior.
Somatic delusions involve the belief that something is physically wrong with the individual. The delusion may involve a medical condition or illness or a perceived deformity. This condition differs from hypochondriasis
in that the deformity is perceived as a fixed condition not a temporary illness.
Mixed delusions are those characterized by two or more of persecutory, grandiose, jealousy, erotomanic, or somatic themes.
Causes and symptoms
Some studies have indicated that delusions may be generated by abnormalities in the limbic system, the portion of the brain on the inner edge of the cerebral cortex that is believed to regulate emotions. The exact source of delusions has not been conclusively found, but potential causes include genetics, neurological abnormalities, and changes in brain chemistry. Delusions are also a known possible side effect of drug use and abuse
(e.g., amphetamines, cocaine
Patients with delusional symptoms should undergo a thorough physical examination
and patient history to rule out possible organic causes (such as dementia). If a psychological cause is suspected, a mental health professional will typically conduct an interview with the patient and administer one of several clinical inventories, or tests, to evaluate mental status.
Delusions that are symptomatic of delusional disorder should be treated by a psychologist and/or psychiatrist. Though antipsychotic drugs
are often not effective, antipsychotic medication such as thioridazine (Mellaril), haloperidol (Haldol), chlorpromazine (Thorazine), clozapine (Clozaril), or risperidone (Risperdal) may be prescribed, and cognitive therapy or psychotherapy may be attempted.
— False or distorted sensory experiences that appear to be real perceptions.
— An unfounded or exaggerated distrust of others.
Shared psychotic disorder
— Also known as folie à deux; shared psychotic disorder is an uncommon disorder in which the same delusion is shared by two or more individuals.
If an underlying condition such as schizophrenia, depression, or drug abuse is found to be triggering the delusions, an appropriate course of medication and/or psychosocial therapy is employed to treat the primary disorder. The medication, typically, will include an antipsychotic agent.
Delusional disorder is typically a chronic condition, but with appropriate treatment, a remission of delusional symptoms occurs in up to 50% of patients. However, because of their strong belief in the reality of their delusions and a lack of insight into their condition, individuals with this disorder may never seek treatment, or may be resistant to exploring their condition in psychotherapy.
American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924. http://www.psych.org.
American Psychological Association (APA). 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. ttp://www.apa.org.
National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264. http://www.nami.org.