Delusions


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Delusions

 

Definition

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.

Description

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.

Persecutory

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.

Grandiose

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."

Jealousy

Jealous delusions are unjustified and irrational beliefs that an individual's spouse or significant other has been unfaithful.

Erotomanic

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

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

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, PCP).

Diagnosis

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.

Treatment

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.

Key terms

Hallucinations — False or distorted sensory experiences that appear to be real perceptions.
Paranoia — 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.

Prognosis

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.

Resources

Organizations

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.

Patient discussion about Delusions

Q. Give life to her please! Here is a really confusing question to you all. But your reply is a life for her. I know someone who is bipolar and she thinks that her ‘brother’ sexually molested her when they were kids. Can this be a delusion? Or hallucinating?

A. Im going to answer this question a little different;What if she is telling the truth,and her brother is planning on no body believing her? because she has this disease?---keep that in mind when you take her to the DR--mrfoot56

More discussions about Delusions
References in classic literature ?
And this effect, as I have intimated, was heightened to its utmost intensity in me, because Bertha was the only being who remained for me in the mysterious seclusion of soul that renders such youthful delusion possible.
Yea, though you should deem yourself entering the gates of the blessed city, it will be nothing but a miserable delusion.
Like most people, I suppose, I've lived almost entirely among delusions, and now I'm at the awkward stage of finding it out.
I only wished they would have done, that we might hasten back to Horton Lodge: I longed to seek the retirement of my own room, or some sequestered nook in the grounds, that I might deliver myself up to my feelings--to weep my last farewell, and lament my false hopes and vain delusions.
Even this, his usual sentiment at meal times, one of his innocent delusions (for his appetite was always obstinate, and flatly contradicted him), awoke no smile in the face of his little wife, who stood among the parcels, pushing the cake-box slowly from her with her foot, and never once looked, though her eyes were cast down too, upon the dainty shoe she generally was so mindful of.
I am sorry to say anything which may disturb popular delusions on the subject of poetical justice, but this is strictly the truth.
Aldersley is, or is not, a living man; and there will be an end of the hysterical delusions which now threaten to fatally undermine her health.
I have read about them, Geordie, and though they are better than the others, I am not satisfied with these optical delusions, as I call them.
His assertion that a peculiarly susceptible subject may be kept in the realm of the unreal for weeks, months, and even years, dominated by whatever delusions and hallucinations the operator may from time to time suggest, is a trifle disquieting.
1932--their mistakes and ignorance, their doubts and fears and misapprehensions, their ethical delusions, their violent passions, their inconceivable sordidness and selfishness.
Mama supposes that these are honourable men, rich and distinguished, and how CAN I--how can I undeceive her--when she is so happy in these little delusions, which are the only happiness she has?
His secret and unworthy long-standing connection with the Government was disclosed, so that his reputation was sadly blemished, and he seems to have gone into hiding, perhaps as the result of half-insane delusions.