The Condition Delusional Disorder: Symptoms And Treatment

The condition of delusional disorder is mainly characterized by at least a month of delusions. In the 17th century, the term madness mostly referred to delusions. Consequently, being “insane” was the same as having delusions and vice versa. What exactly is a delusion?

The best known and most quoted definition is found in Karl Jasper’s Allgemeine Psychopathologie  (1975). He described delusions as false and impossible beliefs held with an unshakable conviction that cannot be influenced by experience or evidence.

To identify a delusion, you must consider the extent to which the experience meets the following criteria:

• The person holds on to his faith with absolute conviction.
• They believe that the truth is completely obvious to everyone.
• Neither rationality nor experience changes their beliefs.

• Belief is often bizarre or at least highly unlikely.
• The other members of the social or cultural group do not share that belief.
• The person is worried about their faith and it is difficult for them to think or talk about it.
• Their beliefs are a source of subjective distress and disrupt their social and personal lives.

As you can see, delusions are conceptually complicated. As a result, it is difficult to get them to fit into a single definition. If you ask a random person on the street to describe an “insane” person today, they will probably describe someone who thinks they are Naples or who thinks aliens are trying to get them.

What is the condition of delusional disorder?

When people think of delusions, they often think of schizophrenia. However, they are two completely different disorders.

A psychologist will not diagnose a patient with the condition delusional disorder if the person has ever met the DSM-5 diagnostic criteria for schizophrenia. Apart from the direct effect of having delusions, the deterioration of psychosocial function may be more limited than in other psychotic disorders.

Someone with the condition of delusional disorder does not behave in a strange or extravagant way. The DSM-5 also emphasizes that the patient’s delusions cannot be attributed to side effects of drug abuse (ie cocaine) or other medical conditions (eg Alzheimer’s disease). Medical personnel must also rule out other mental disorders that will better explain the symptoms (such as dysmorphophobia or obsessive-compulsive disorder).

DSM-5 diagnostic criteria for delusion

The Diagnostic and Statistical Manual of Mental Disorder (DSM-5) contains the following diagnostic criteria for delusional disorder:

A. Presence of one or more delusions lasting one month or more.

B. Diagnostic criteria for schizophrenia have never been met. Note: Hallucinations, if present, are not prominent and are clearly thematically related to the delusional theme (eg the feeling of being infected with insects is associated with infestation illusions).

C. Apart from the effect of the delusion (s) or its ramifications, the patient’s function is not significantly impaired, and the behavior is clearly not bizarre or strange.

D. If manic or severe depressive episodes have occurred, then these have been short in relation to the duration of the symptoms of delusions.

E. The disorder is not better explained by another mental disorder, such as obsessive-compulsive disorder, and cannot be attributed to the physiological effects of a drug or medication or another systemic medical condition.

What types of delusions are there?

The DSM-5 also defines the types of delusions that exist:

• Erotomani. People with this delusion believe that someone is in love with them.
• Grandios. Some people with this type of delusion believe that they have a special and unknown talent or knowledge, or that they have made an important discovery.
• Jealous. This type describes people who have delusions about their partner or boyfriend being unfaithful.

• Persecution. People with this type of delusion believe that others are conspiring, tricking, spying, persecuting, drugging, defaming, harassing, or preventing them from achieving their long-term goals in some way.
• Somatic. Delusions are somatic when they have to do with bodily functions or emotions.
• Mixed. When people have two or more of the delusions listed above.

Treatment for delusions

The condition of delusional disorder is difficult to treat. Healthcare professionals often prescribe antipsychotic, antidepressant, and mood-stabilizing medications for psychotic disorders. Similarly, many professionals use psychological therapy to treat it. However, there is still a lot of room for improvement.

Currently, there is no special treatment for delusions that gives significantly better results than others. Until psychologists find a specific intervention that gives better results, then the treatment for delusions will probably be based on those that are considered effective for other psychotic disorders and mental health conditions.