Delusional Disorders


Delusion is a disorder that implies deeply-rooted and difficult-to-change beliefs or illusions. According to psychologist Emil Kraepelin, “patients with delusional disorders are consistent, reasonable, and moderate”; as such, the delusions are not caused by the effects of medications, drugs, or ordinary illnesses. Since the disorder is not related to a person’s IQ, patients can perform effectively in daily life; they might also not exhibit any strange or odd behaviors. Delusional disorders are categorized into types; including:

  • Persecutory delusion is one of the most common types; patients believe they are being stalked, harassed, deceived, or plotted against, or that their endeavors are being purposefully hindered. In other cases, the delusions function like a comprehensive system of thoughts that controls the patient.
  • Grandiose delusion is when patients believe they have special gifts or abilities, and that they are celebrities or public figures. A common case is believing that one achieved something great and has not received appropriate recognition.
  • The delusion of guilt, sin, or self-accusation is when patients are convinced that they are responsible for the occurrence of any disaster; be it a fire, a flood, or an earthquake, which cannot really be their fault. If not addressed by treatment, this type of delusion could cause depression.
  • Somatic delusion is commonly manifested by questioning one's odor, physical appearance, or bodily functioning.
  • The delusion of control is when patients falsely believe that other persons, group of people or external forces control their thoughts, feelings, impulses, or behaviors.
  • Mind-reading delusion is when patients falsely believe that another person can read their thoughts.
  • Cotard delusion is when patients feel that they, or some of their body parts, do not exist, or that people around them do not exist.
  • Delusional parasitosis is when patients feel infested with insects, bacteria, or other micro-organisms; they might heavily visit dermatologists and overuse medications.
  • Mixed delusions involve the symptoms of more than one of the above-mentioned types, without being entirely control by a specific type.

According to the Diagnostic and Statistical Manual of Mental Disorders, a delusion should continue for a month or more. Delusional disorders could cause harm; hence, it is essential that the patient receives appropriate medical care. Disorders could be acute; they develop over the course of two to twelve weeks, and they could become chronic if they continue beyond 3 months.

Starting with behavioral therapy and psychoeducation, treatment implies building a relationship of trust between the therapist and the patient. Treatment can bring about behavioral changes, such as enhancing the patient's relationships and solving problems that worsened due to the delusion. This phase of therapy can be long; it could take up to six months to a whole year to witness progress. Then comes the phase of social and psychological therapy, which includes individual or group therapy sessions. It comprises different approaches, such as hypnosis, persuasion, cognitive therapy, and Gestalt therapy known for their effectiveness in linking the individual with reality. The last phase includes consuming anti-psychosis medications, which help the patients get over 50% of the symptoms. At least, 90% of the cases witness improvement in some symptoms.


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