Delusional Disorder

Definition of Delusional Disorder

A person with a delusional disorder has beliefs or perceptions that he or she thinks are true, but which are illogical or wrong. The person cannot be dissuaded from their belief, which is fixed in his or her mind. These beliefs or perceptions often last for at least a month. There are six types of delusions:

• Erotomanic type. A person with this type of delusion believes that another person, usually of higher status, is in love with him or her. This other person may be a boss or coworker, a celebrity, or a stranger.
• Grandiose type. A person with this type of delusion believes that he or she is much more important, powerful, wealthy, or talented than he or she really is.
• Jealous type. A person with this type of delusion believes that his or her partner has been unfaithful.
• Persecutory type. A person with this type of delusion believes that he or she is being plotted against, spied on, or harassed by unknown enemies.
• Somatic type. A person with this type of delusion believes he or she is ill or has other types of health problems.
• Mixed type. A person with this type of delusion suffers from more than one of the delusions listed above.

What is going on in the body?

This condition, like most psychological disorders, is related both to chemical imbalances in the brain and to external environmental influences. The precise mechanism of causation of delusional disorders is unknown, and may well differ from person to person.

What are the signs and symptoms of the condition?

Symptoms of this disorder depend on the type of delusion, but may include:

• being irritable
• doubting the loyalty of friends
• feeling alone
• feeling taken advantage of
• finding hidden meaning in events or remarks
• having trouble with social and marital relationships
• holding grudges for a long time

What are the causes and risks of the condition?

This disorder usually begins when a person is between the ages of 40 and 55 but may occur at a younger age. It affects less than 1% of the population. It occurs with equal frequency in men and women. Risk factors for the disorder include:

• neurological conditions associated with aging
• alcoholism
• deafness
• head injury
• stress

What can be done to prevent the condition?

There is no known way to prevent this condition.

How is the condition diagnosed?

A healthcare professional will take a complete medical history and do a physical exam. Lab tests are usually done to rule out other health problems that could be causing the delusions.

What are the long-term effects of the condition?

This disorder usually lasts for many years. It may interfere with social and marital relationships.

What are the risks to others?

Some people with this disorder may become violent, or otherwise act on their delusions in destructive ways toward others.

What are the treatments for the condition?

The long-term goal of treatment is to correct the behavior and mood disturbances that result from the delusions. To do this, a positive relationship with the healthcare professional is helpful.

If the person is dangerous to himself or others, he or she may need to be hospitalized. Medicine may be prescribed. Antipsychotic medicines can reduce the intensity of the delusion as well as improve anxiety and agitation. Antidepressant medicines may be used to control other symptoms.

What are the side effects of the treatments?

Side effects of medicines may include drowsiness, dizziness, excessive salivation, and increased heart rate, weight gain, diabetes, increased risk of cardiovascular disease, reduced sexual interest, restlessness, muscle stiffness, movement disorders, and shaking.

What happens after treatment for the condition?

Delusional disorder usually does not lead to severe impairment or changes in personality. Most people do well and are able to remain employed.

How is the condition monitored?

The person is asked to monitor his or her symptoms and report them to the healthcare professional. Regular checkups are needed because medicines may need to be adjusted.