Delusional Disorder

Schizophrenia	Types of Schizophrenia
Psychotic Symptoms	Schizoaffective Disorder
Delusional Disorder	Schizophreniform Disorder
Shared Psychotic Disorder	Brief Psychotic Disorder

Delusional disorder is characterized by the presence of irrational, false beliefs that have existed for at least one month's duration. A number of subtypes of delusional disorder exist, and the illness can take many forms, but in all cases the individual's delusion is nonbizarre - meaning it consists of something that could occur in reality.

Individuals tend to be in their 40's when the illness strikes, although men and woman of any age can develop the disorder. Most do not realize that they have a delusional disorder until it is pointed out by family, friends or coworkers. Few voluntarily seek treatment as they feel there is nothing wrong, and individuals suffering from delusional disorder generally do not experience a marked impairment in their daily functioning.

The cause of delusional disorder is not known at this time. Some studies have suggested a biological or genetic component to the illness, and those with a first degree relative with the disorder appear to be at a greater risk of developing symptoms.

Symptoms of Delusional Disorder:

Individuals with delusional disorder have firmly held beliefs that are not shared by those around them. These beliefs are not bizarre, but are also not true. Some of the most common delusions seen in this disorder are listed below:

- A belief of being persecuted, conspired against, cheated, spied on, followed, or lied to

- A belief that the individual has some serious physical condition or abnormality such as a deformity or disfigurement, or an unpleasant odor

- A belief that the individual is loved or greatly admired by a public or famous figure

- A belief of having some great but unrecognized talent, position, or purpose

- Jealously about a spouse or partner being unfaithful

DSM-IV Criteria:

A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration.

B. Criterion A for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme.

C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.

D. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type (the following types are assigned based on the predominant delusional theme):

* Erotomanic Type: delusions that another person, usually of higher status, is in love with the individual

* Grandiose Type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person

* Jealous Type: delusions that the individual's sexual partner is unfaithful

* Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way

* Somatic Type: delusions that the person has some physical defect or general medical condition

* Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates

* Unspecified Type

Treatment of Delusional Disorder:

Delusional disorder can be effectively treated and people can recover, however, the earlier effective treatment is started, the better are the chances of recovery. Inpatient hospitalization may be needed in some cases, although most individuals do well on an outpatient basis.

Medication:
Medications can be very helpful but are often refused due to the lack of insight the delusional individual has. Antipsychotic medications are the most common type of medication used to treat this disorder, but other medications such as tranquilizers and antidepressants may also be of value.

Psychotherapy:
Therapy can be an effective way of teaching methods of identifying irrational beliefs, as well as ways to cope with the symptoms of the disorder. Cognitive behavioral therapy (CBT) may be used to help individuals with delusional disorder learn how to overcome persistent symptoms.