Delusional Disorder: Information, Symptoms, Treatment and More

Delusional Disorder is a serious mental health condition characterised by the appearance of delusions in an individual, albeit without any other signs of psychosis.

A delusion is where an individual believes something that is irrational and false. Yet the person will have confidence in their abnormal belief being true, refusing to be swayed by others’ dismissals.

Examples of delusions include the feeling that someone is spying on an individual, or that someone is out to do an individual some harm.

Delusional disorder is a rare condition, and can cause distress. While being similar to other conditions that include delusions such as Schizophrenia or Bipolar Disorder, Delusional Disorder differs from these disorders, and is itself a diagnosis.

What are the symptoms of Delusional Disorder?

There are actually six different types of Delusional Disorder. The sub-types each account for certain symptoms – in line with the nature of the individual’s delusion.

First of all, for an individual to suffer from Delusional Disorder, they will exhibit a delusion. This delusion cannot be accompanied by any other form of psychosis like a hallucination in this condition.

Delusions: A delusion is where an individual has a belief that they believe steadfastly in, though isn’t true. The person involved will be adamant that their belief is true. In the majority of cases however, they will not be correct. Delusions can take on a wide array of forms. An example of a delusion is paranoia – such as the feeling an individual is being spied on. As such, the delusion can have a marked effect on the day-to-day life of the individual.

The six sub-types of Delusional Disorder are:

• Erotomania: This is where the individual believes someone is in love with them, often a celebrity. The person as a result will often try and contact that person, perhaps going to great lengths to do so. This behaviour often leads to stalking ensuing.
• Grandiose: This sub-type involves an individual having an inflated sense of power, knowledge, worth, or that they believe they are famous.
• Persecutory: This area involves an individual believing they or someone close to them are being discriminated against, being wronged, or are being spied on, with someone planning on harming them. This often leads to an individual complaining to law enforcement officials about their beliefs. This delusion, featured around persecution, is one of the most common forms of this disorder.
• Somatic: This delusion is based on the idea that the individual has a medical condition or some form of physical defect. They may wrongfully call an ambulance for their condition, or go to a A&E complaining of something being wrong with them.
• Jealous: The jealous sub-type is based around an individual believing that their partner is being unfaithful to them – even though there is no evidence to back this up. The individual may go to great lengths to ‘catch’ the person in the act, by following them, reading text messages or emails, or any other way to try and find ‘evidence’ of their supposed indiscretion.
• Mixed: Someone suffering from a mixed Delusional disorder will have two or more of the types of delusions running concurrently.

For more information, we have an article that explores these six different types of delusions in more detail.

It is common for an individual to be irritable or angry at others when they dismiss their delusion as being false. This is because the individual believes wholeheartedly in the truth of their belief.

The delusion will often have a strong influence on the life of the individual. The individual may tend to act strangely when confronted about their delusion.

They may be humourless or oversensitive towards the delusion, and regardless of how much someone tries to prove them wrong, the individual will refuse to even entertain the possibility they are incorrect.

Of course sometimes delusions can go on to be true, which has led to some criticism of this psychotic disorder. As delusions can rarely be looked into by a professional, there is sometimes the potential for them to be true. For example, this is evidenced by the infamous Watergate Scandal and the story of Martha Mitchell.

What are the causes of Delusional Disorder?

The cause of Delusional Disorder is not known. Similarly, it isn’t known why some people develop Delusional Disorder, but don’t go on to develop more severe psychotic disorders like Schizophrenia.

Most research suggests that rather than there being just one cause, that a range of factors may contribute to the onset of the condition.

In any condition involving psychosis, some areas of the brain appear to feature either abnormally high or a deficiency in certain chemicals. This is believed to be linked to a mental illness developing.

For instance, the chemical dopamine in the brain is linked to psychotic episodes when abnormally high levels are present. Traumatic or highly-stressful experiences can cause any mental health condition to arise.

Moreover, substance abuse, especially involving high-strength Cannabis, is another risk factor for psychosis.

Diagnosis of Delusional Disorder

It is important for an individual to see a Doctor or mental health professional if they believe they are suffering from Delusional Disorder, or are suffering from any symptoms of psychosis.

Due to the individual not being aware of their belief being delusional, it will often be up to a friend or family member to try and instigate treatment – which can prove difficult.

There is no laboratory test or other medical examination that can determine whether or not an individual has Delusional Disorder. However, a blood or other test can be carried out. This would be to rule out other illnesses that may be causing the symptoms, such as Alzheimer’s disease or Epilepsy.

It is also possible the symptoms will be more suited to a different mental illness like Schizoaffective Disorder.

A Doctor will aim to make a diagnosis based on a face-to-face appointment. They will ask a series of questions, normally based around the severity of symptoms, how long the delusion has been present, possible causes, and general queries regarding any family history of mental illness.

A family member or close friend may also be questioned in order to find out a second opinion of the Delusional Disorder and its consequences on the life of the individual.

If Delusional Disorder is suspected, the individual will normally be referred to a specialist for a more in-depth assessment.

The individual will consequently meet with a mental health specialist, where an in-depth assessment into the individual’s symptoms will be conducted.

For Delusional Disorder to be diagnosed, the following criteria should be generally met:

• The individual exhibits at least one (sometimes more) delusion(s)
• This delusion has lasted at least one month
• The individual has no history of hallucinations, nor has been diagnosed with Schizophrenia or Schizoaffective Disorder in the past
• The behaviour of the individual hasn’t been significantly affected by their delusion
• Serious mood states e.g. depression or mania, haven’t been present
• The symptoms of the disorder aren’t better suited to an alternative diagnosis e.g. Schizophrenia
• Substance abuse has not caused the symptoms

How is Delusional Disorder treated?

While Delusional Disorder may not be as severe as other psychotic disorders, it still has the potential to cause distress. The good news is that treatment is available, with a full recovery sometimes possible.

The individual affected may not be willing to engage in treatment, which can act as a complication. Treatment for Delusional Disorder normally includes:

Talking Therapy

Some form of talking therapy can prove useful with Delusional Disorder. It is normally recommended that the Socratic questioning technique is adopted for use in Delusional Disorder.

This involves asking the patient open-ended questions. This is because it may lead an individual to realise there is no evidence for their beliefs.

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

There are a wide range of other types of talking therapies available. We have more information about therapy on our Therapy section.

Medication

Antipsychotics may be prescribed in an effort to lessen the symptoms of this condition. While medication sometimes will not work, it can help in some cases.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Other

Hospitalisation is rare in cases of Delusional Disorder. However, given the propensity for an individual to act violently when in a psychotic state, the chance of hospitalisation cannot be ruled out.

This would only ever happen in cases where an individual is deemed to be a danger to themselves or others due to their symptoms.

Summary

Seeking help for Delusional Disorder is important. Due to the nature of the condition, it may need someone else to help the individual seek treatment.

Treatment can certainly help, and should result in a higher quality of life being attained. For more information, take a look around our website.

See Also

• Psychosis Section
• What is the Prognosis for Psychosis?
• Therapy Homepage
• Medicine Homepage