Delusional Disorder: Definition, Types, Causes, Symptoms, And Treatments.

The delusional disorder , formerly called disorder paranoid , is a type of severe mental illness, called “psychosis” in which a person can not distinguish the real from what is imagined. The main characteristic of this disorder is the presence of delusions, which are unshakable beliefs in something false, people experience non-strange delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired or loved by distance. These delusions usually involve the misinterpretation of perceptions or experiences.

People with delusional disorder can continue to socialize, this is different from people with other psychotic disorders , who can also have delusions as a symptom of their disorder. In some cases, they may be so preoccupied with their delusions that their lives are affected.

Although delusions can be a symptom of more common disorders, such as schizophrenia , delusional disorder itself is quite rare, delusional disorder occurs more often in middle or late life.

Types of delusional disorder

There are different types based on the main theme of experienced hoaxes. Which include:

Erotomaníaco

A person with this type of disorder believes that another person, someone important or famous, is in love with him or her. Efforts to contact the target of deception through phone calls, letters, surveillance, or stalking are common and may conflict with the law related to this behavior.

Megalomania

A person with this delusional disorder has an inflated sense of worth, power, knowledge or identity, may believe that they have great talent, or have made an important discovery.

Celotypic

A person believes that their spouse or sexual partner is unfaithful to them. This belief is based on incorrect inferences supported by dubious evidence, they can resort to physical abuse.

Persecutory

Patients believe they are being conspired, spied on, defamed or harassed, may repeatedly attempt to obtain justice through appeals to the courts and other government agencies, and may resort to violence in retaliation for the imagined persecution.

Somatic

A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.

Mixed

People with this type of delusional disorder have two or more of the types of delusions listed above.

Not specified

An individual’s delusions do not fall into the categories described or cannot be clearly determined.

What Causes Delusional Disorder?

As with many other psychotic disorders, the exact cause is not yet known. However, researchers are looking at the role of various genetic, biological, and environmental or psychological factors.

Genetic

The fact that delusional disorder is more common in people who have family members who have it or schizophrenia suggests that there could be a genetic factor involved. It is believed that, as with other mental disorders , the tendency to develop a delusional disorder could be passed down from parent to child.

Biological

Researchers are studying how abnormalities in certain areas of the brain could be involved in development; an imbalance of certain chemicals in the brain, called neurotransmitters, has also been linked to the formation of delusional symptoms. Neurotransmitters are substances that help nerve cells in the brain send messages to each other; an imbalance in these chemicals can interfere with the transmission of messages, leading to symptoms.

Environmental / psychological

Evidence suggests that delusional disorder can be triggered by stress, and alcohol and drug abuse can also contribute to the condition. People who tend to be isolated, such as immigrants or those with poor vision and hearing, appear to be more vulnerable to developing this disorder.

Signs and symptoms of delusional disorder

• The patient expresses an idea or belief with unusual persistence or strength.
• That idea seems to have an undue influence on the life of the patient, and the way of life is altered to an inexplicable degree.
• Despite his deep conviction, there is a quality of secrecy or suspicion when the patient is questioned about it.
• The individual tends to be lacking in a sense of humor and overly sensitive, especially about belief.
• There is a quality of centrality: no matter how unlikely it is that these strange things will happen to him, the patient accepts them relatively unquestioningly.
• An attempt to contradict the belief is likely to provoke an unduly strong emotional reaction, often with irritability and hostility.
• The belief is at least unlikely and is outside the social, cultural, and religious background of the patient.
• The patient is emotionally over-invested in the idea and overwhelms other elements of his psyche.
• Cheating, if acted upon, often leads to behaviors that are abnormal and / or out of character, although perhaps understandable in light of delusional beliefs.
• People who know the patient observe that the belief and behavior are unusual and strange.

Characteristics of delusional disorder

• It is a primary disorder.
• It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.
• The disease is chronic and often lifelong.
• Delusions are logically constructed and internally consistent.
• Delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is generally no general disturbance in behavior. If disturbed behavior occurs, it is directly related to delusional beliefs.
• The individual experiences a greater sense of self-reference. Events that are not significant to others are of enormous importance to him or her, and the atmosphere surrounding delusions is highly charged.

How is delusional disorder diagnosed?

If there are symptoms, your doctor will likely perform a complete medical history and physical examination, although there are no laboratory tests to specifically diagnose delusional disorder, the doctor may use various diagnostic tests, such as imaging studies or blood tests, to rule out physical illness as the cause of symptoms.

If the doctor does not find a physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, health professionals who are specially trained to diagnose and treat mental illness. Psychiatrists and psychologists use specially designed interview and evaluation tools to evaluate a person for a psychotic disorder, on the other hand the doctor or therapist bases their diagnosis on the report of the person’s symptoms and their observation of the attitude and behavior. then determine if the person’s symptoms point to a specific disorder.

A diagnosis of delusional disorder is made if a person has non-bizarre delusions for at least a month and does not have the characteristic symptoms of other psychotic disorders, such as schizophrenia.

How is delusional disorder treated?

Treatment most often includes medications and psychotherapy (a type of counseling). Delusional disorder can be very difficult to treat, in part because sufferers often have poor perception and do not recognize that there is a psychiatric problem. Studies show that nearly half of the patients treated with antipsychotic medications show at least partial improvement.

Antipsychotic medications are the main treatment for delusional disorder. Sometimes psychotherapy can also be a useful adjunct to medication as a way to help patients better manage and cope with the stresses related to their delusional beliefs and their impact on their lives.

Therapies

• Psychotherapy: It can help the person to recognize and correct theunderlyingthinkingthat has been distorted.
• Cognitive behavioral therapy: It can help the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings.
• Family therapy : It  can help families deal more effectively with a loved one who has a delusional disorder, allowing them to contribute to a better outcome for the person.

Medicines

Conventional antipsychotics:  Also called neuroleptics, they have been used to treat mental disorders since the mid-1950s and work by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter that is believed to be involved in the development of delusions. Conventional antipsychotics include Thorazine, Loxapine, Prolixin, Haldol, Navane, Stelazine, Trilafon, and Mellaril.

Atypical antipsychotics:  These newer medications appear to be effective in treating delusional disorder symptoms with fewer movement-related side effects than older typical antipsychotics, they work by blocking dopamine and serotonin receptors in the brain. Serotonin is another neurotransmitter believed to be involved in delusional disorder, these medications include Risperdal, Clozaril, Seroquel, Geodon, and Zyprexa.

Other medications:  Tranquilizers and antidepressants can also be used to treat anxiety or mood symptoms if they occur in combination with a delusional disorder, tranquilizers can be used if the person has a very high level of anxiety or trouble sleeping . Antidepressants can be used to treat depression , which often occurs in people with delusional disorder

People with severe symptoms or who are at risk of hurting themselves or others may need to be hospitalized until the situation stabilizes.