VERIFIED CONTENTAuthor: Krzysztof Bialazite

Delusions are wrong, inconsistent with reality or belief. Delusions, belonging to disorders of the content of thinking, may occur in the course of various mental illnesses. Learn how to recognize delusions, the types of delusions in which mental illnesses are delusional, and how to treat a delusional disorder.

Delusionsare an example of a disturbance in the content of thinking. Strongly developed delusional systems are a typical symptom of schizophrenia. A characteristic feature of delusions is the complete lack of susceptibility to persuasion. The patient's beliefs do not change despite the evidence of a misinterpretation of reality.

What are delusions?

Delusions are misconceptions and beliefs that can affect many areas of life. Delusions can refer to current events, perception of oneself and other people, interpretation of reality and the immediate environment.

The distinguishing feature of delusions is their rigidity and lack of argumentation. The patient perceives his delusions indiscriminately - he rejects any evidence that his beliefs are untrue. Delusional disorders cause significant emotional suffering - the patient feels misunderstood, perceives the world as dangerous and dangerous.

The presence of delusions can dominate other areas of life. Patients often interpret reality solely through the prism of their false beliefs.

Delusions and mental disorders

Delusions can be a symptom of a wide variety of mental disorders. Delusional syndromes can be complex in many ways. The most basic form is simple delusions, i.e. single false judgments and beliefs.

When there are multiple delusions about different areas of life, we are talking about the delusional syndrome. An example of such a syndrome are paranoid delusions, i.e. a system of coherent, logical beliefs.

A characteristic feature of paranoid delusions is the theoretical possibility of their occurrence. These include, but are not limited to, delusions of betrayal, poisoning or being bullied.

If the delusional system is inconsistent and concerns impossible events, we are talking about a paranoid syndrome. This type of delusion is a common symptom of paranoid schizophrenia.Examples of paranoid delusions are the delusions of revealing thoughts or the delusions of being possessed by "alien forces." The paranoid syndrome causes a significant deterioration in the functioning of the patient in all areas of life.

Although the occurrence of delusions is most often associated with the diagnosis of schizophrenia, it is worth remembering that delusions can occur in many other mental disorders.

Delusions of size may appear in mania, while nihilistic delusions - in severe depressive syndromes.

Systematic, coherent delusions without an accompanying disintegration of the personality structure are so-called persistent delusional disorders (formerly called "paranoia").

The mere existence of delusions is not the basis for a diagnosis of any mental disorder. A complete psychiatric examination is necessary to make a diagnosis.

Types of delusions

Delusions can affect many areas of the patient's life. Their content is often related to the socio-cultural context and living environment of the patient. The common trait of all delusions is that they are not susceptible to persuasion. Here are the most common delusional content:

  • ksawki - the patient relates everyday situations and ordinary events to himself, considers himself the "center of events" and the object of interest of other people. He believes that he is the subject of talks, and messages from the media (radio, television, newspapers) refer to him.
  • persecutory - the patient believes that he or she is the target of persecution of a person or group of people who want to harm him. The patient feels watched, followed. Persecution delusions may be accompanied by hostility towards family members or other people from the immediate environment, which results from a constant sense of danger.
  • poisoning - the sick person thinks that other people (family, neighbors) want to poison him. The patient may be convinced of adding poison to food or letting gas into the apartment.
  • grandiose - the patient is convinced of his greatness and uniqueness, may believe that he has descended from heaven or is a messenger with an important mission to fulfill. The sick person does not adequately perceive their material status, social position, knowledge and skills. The patient may introduce himself as a well-known and respected person (a popular politician, a distinguished historical figure).
  • hypochondriac - the patient is convinced that he suffers from a serious disease that destroys his body. Hypochondriac delusions are devoid of logic and reality (belief in the breakdown of internal organs, invasion of parasites).
  • jealousy - most often they concern the person with whom the patient is in a partner relationship. The sick person is convinced of being cheated on. Normal eventsand interprets everyday situations as evidence of unfaithfulness. The patient can spy on the other person, constantly looking for evidence of treason.
  • erotic - the patient is convinced that a person is in love with him, considers himself an object of sexual desire
  • dysmorphophobic - the patient inadequately perceives his body parts, considers his appearance unfavorable
  • depressive - delusions undermining the patient's value as a person are typical of the depressive syndrome. The sick person feels humiliated, sinful, guilty, and not deserving of happiness. Nihilistic delusions consist in the belief that you and the world around you do not exist.
  • influences - the patient believes that external forces or other people control his thoughts and actions. They are often convinced that they have an implanted device (chip) that controls their person.

Special delusional syndromes

Delusions can occur in the course of many different mental disorders. Sometimes the content of the delusions and the accompanying symptoms are so specific that they create separate disease entities. Specific syndromes associated with the presence of delusions include:

Othello's team

This is otherwise alcoholic paranoia. Othello's syndrome occurs in people who abuse alcohol (most often in long-term alcoholics). Its predominant feature is the presence of delusions of infidelity. The patient is convinced of being cheated on and is constantly looking for evidence to confirm his assumptions.

The thoughts and behaviors of the sick person constantly revolve around the topic of partner infidelity. The circle of "suspects" is constantly expanding - from neighbors, through family members, to complete strangers. The delusional attitude often leads to investigations, controlling each step of the partner, can also be a factor in causing violence.

Othello's syndrome is chronic and its treatment is long-term and not always effective. The first step in the treatment of this disorder is the treatment of alcohol dependence.

de Clérambault's team

This is a complex of erotic delusions. The patient is convinced that another person, most often known and holding a high social position, is in love with him. The object of delusions can be politicians, people known from the media, or other people with a significantly higher status than the patient.

De Clérambault's syndrome is sometimes the cause of the solicitation and persecution of the patient's delusional object. The patient closely observes the object of his love and interprets ordinary words and gestures as "signs" that are proofs of his love.

In the late stages of de Clérambault's syndrome, aggression and acts of violence can occur, bothtowards the object of falling in love, as well as people who, in the patient's opinion, stand in the way of their relationship.

Capgras team

This is a rare but very interesting delusional syndrome. The main symptom of Capgras syndrome is the patient's belief that his family members have been replaced by doubles. The patient thinks that he is surrounded by complete strangers, pretending to be his relatives.

The causes of Capgras syndrome have not been fully understood so far. However, it is suspected that the underlying cause of the misidentification of loved ones is specific disorders of the brain function - loss of connections between the facial recognition center and the limbic system, responsible for the regulation of emotions.

Cotard's team

This is an example of a delusional syndrome typical of severe depression. Delusions in Cotard's syndrome are nihilistic - the patient is convinced that his body has decayed and that he is dead.

For this reason, Cotard's syndrome is sometimes called "the walking dead syndrome". Delusions in Cotard's syndrome can lead to neglect, food and fluid refusal, as well as self-harm and suicide.

Insanity granted (folie à deux)

This is a special type of delusional disorder that develops a person who is closely related to a paranoid patient. This disorder most often occurs in a family member of the patient. At the root of the insanity granted is prolonged exposure to a delusional person and often coexisting social isolation from other people.

In addition to the mechanism of induced paranoia, the method of treating this disorder is also interesting. In most cases, it is sufficient to isolate those who share the same delusions. In the person affected by the insanity, the delusions may be completely extinguished.

Delusional treatment

Delusions are a symptom that causes great anxiety in the patient's relatives. Due to their uncorrectable nature, the patient does not interpret his thoughts in terms of disease. Usually, a visit to a doctor takes place on the initiative of the closest people or in the event of the appearance of additional symptoms.

It is worth remembering that delusions alone are not the basis for the diagnosis of any mental illness. Delusion is a symptom that can occur in a variety of diseases. In order to effectively help the patient, the first step should be a thorough psychiatric examination and proper diagnosis.

The diagnostic process aims to answer the question of where the delusions came from in the patient's mind. In many cases, they are rooted in a mental illness such as schizophrenia or an affective disorderbipolar.

In some patients, the occurrence of delusions may be associated with the abuse of psychoactive substances (alcohol, drugs). Sometimes delusions are caused by the patient's somatic state or a coexisting neurological disease.

You should always try to determine whether delusions are the only abnormality in the patient or whether they are accompanied by other symptoms of mental disorders. Information obtained from the patient's relatives is a valuable diagnostic clue.

Most delusions are permanent, therefore their therapy should be comprehensive and long-lasting. The basis of treatment is appropriately selected drugs. Depending on the underlying disease, you may need to take antipsychotic, mood stabilizing or antidepressant medications.

In addition to pharmacotherapy, it is very important to maintain patient compliance in the treatment. For this purpose, psychoeducation is used, i.e. various methods of conveying to the patient the knowledge about his disease, its causes and symptoms.

Properly conducted psychoeducation aims to provide the patient with an insight into their own mental state and create conditions for proper cooperation in treatment.

Category:

Psychiatry