Delusional Disorder Symptoms, Causes and Treatments

The delusional disorder It is characterized by having a delusion, that is, a persistent belief that does not correspond to reality. It is a belief that people in a society generally do not have..

In this disorder, there are no other characteristics of schizophrenia such as flat affect, negative symptoms or anhedonia. While in schizophrenia there are very strange beliefs, those of this disorder could occur in real life, even if they do not correspond to it..

Examples of people with this disorder would be a man who believes that the police are after him or a woman who believes that they want to poison him.

Persistent delirium is not the result of organ, brain, or other psychosis failure and can last for several years.

Another characteristic is that people can be socially isolated since they tend to distrust others. Because these characteristics tend to occur more in people who have relatives with the same disorder, it seems that there is a hereditary component to its appearance.

Also, some scientists have suggested that social isolation or stressful experiences can play a role in many cases. On the other hand, it is important to bear in mind that delusions are not attributable only to this disorder, but to other conditions:

• Alcohol abuse.
• Drugs abuse.
• Brain tumors.

Article index

• 1 Types of delusional disorder
• 2 Symptoms of delirium
• 3 Causes
• 4 Epidemiology
• 5 Diagnostic Criteria for Delusional Disorder (DSM IV)
• 6 Treatment
• 7 Complications and comorbidity
• 8 References

Types of delusional disorder

There are the following types:

• Greatness: the person believes too much in their own worth.
• Erotomania: the person believes that another person loves them, usually of upper economic class.
• Somatic - the person believes they have a medical or physical problem.
• Persecution: the person believes that others treat him badly.
• Mixed: delusions are of more than one type of the above.

Symptoms of delirium

The following symptoms may indicate a delirium:

• The person expresses an idea or belief with unusual strength or persistence.
• The idea seems to have an undue influence on the person's life and the way of life is altered to an inexplicable degree.
• Despite their deep conviction, there may be some suspicion when the patient is questioned about it.
• The person usually has little sense of humor and feels very sensitive about the belief.
• The person accepts the belief without question even if what happens to him is unlikely or strange things.
• An attempt to contradict the belief may elicit an inappropriate emotional reaction of irritability and hostility..
• The belief is unlikely based on the person's social, religious and cultural past.
• The belief can lead to abnormal behaviors, although understandable in light of the belief.
• People who know the patient observe that the beliefs and behaviors are strange.

Causes

The cause of delusional disorder is unknown, although genetic, biomedical, and environmental factors may play a role..

Some people with this disorder may have an imbalance of neurotransmitters, chemicals that send and receive messages in the brain.

There seems to be a family component, social isolation, immigration (persecutory reasons), drug abuse, being married, being unemployed, excessive stress, low socioeconomic status, celibacy in men and widowhood in women.

epidemiology

In psychiatric practice, this disorder is rare. The prevalence of this condition is 24-30 cases per 100,000 people while there are 0.7-3 new cases each year..

It tends to appear from mid-adulthood to early old age, and most hospital admissions occur between the ages of 33 and 55..

It is more common in women than in men, and immigrants appear to be at higher risk.

Diagnostic criteria for delusional disorder (DSM IV)

A) Non-strange delusional ideas that involve situations that occur in real life such as: being followed, poisoned, infected, loved at a distance or cheated on, having a disease ... At least 1 month in duration.

B) Criterion A for schizophrenia has not been met (1 month of delusions, hallucinations, disorganized language, catatonic behavior, and negative symptoms).

C) Except for the impact of delusions or their ramifications, the psychosocial activity of the person is not significantly impaired and the behavior is not rare or strange.

D) If there have been simultaneous affective episodes with the delusions, their total duration has been short in relation to the duration of the delusional periods.

E) The alteration is not due to the physiological effects of substances (medications or drugs) or medical diseases.

Treatment

Treatment of delusional disorder often includes medication and psychotherapy. It can be very difficult to treat because people who suffer from it have difficulty recognizing that there is a psychotic problem.

Studies show that half of the patients treated with antipsychotic medication show at least 50% improvement.

The main treatments are:

-Family therapy - can help families deal more effectively with the person with the disorder.

-Cognitive-behavioral psychotherapy: can help the person recognize and change behavior patterns that lead to troublesome feelings.

-Antipsychotics: Also called neuroleptics, they have been used since the mid-1950s to treat mental disorders 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 are Thorazine, Loxapine, Prolixin, Haldol, Navane, Stelazine, Trilafon, and Mellaril. 

-Atypical antipsychoticsThese new drugs appear to be effective in treating symptoms of delusional disorder, also with fewer side effects than conventional antipsychotics. They work by blocking serotonin and dopamine receptors in the brain. These drugs include: Risperdal, Clozaril, Seroquel, Geodon, and Zyprexa.

-Other medication- Antidepressants and anxiolytics can be used to calm anxiety, if combined with symptoms of this disorder.

A challenge in treating patients with this disorder is that most do not recognize that there is a problem..

Most are treated as outpatients, although hospitalization may be required if there is a risk of harm to others.

Complications and comorbidity

• People with this disorder can develop depression, often as a result of difficulties associated with delusions..
• Delusions can lead to legal problems.
• Social isolation and interfering with personal relationships.

References

1. Manschreck TC. Delusional and Shared Psychotic Disorder. Kaplan & Sadock's Comprehensive Textbook of Psychiatry 7th ed.
2. Turkington D, Kington D, Weiden P. Cognitive-behavior therapy for schizophrenia: a review. Current Opinions Psychiatry. 2005; 18 (2): 159-63.
3. Grohol, John. "Delusional Disorder Treatment". Psych Central. Retrieved 24 November 2011.
4. Winokur, George. ”Comprehensive Psychiatry-Delusional Disorder” American Psychiatric Association. 1977. p 513.
5. Shivani Chopra, MD; Chief Editor et al. "Delusional Disorder - Epidemiology - Patient demographics". Retrieved 2013-04-15.
6. Kay DWK. “Assessment of familial risks in the functional psychoses and their application in genetic counseling. Br J Pschychiatry. " 1978. p385-390.
7. Semple.David. ”Oxford Hand Book of Psychiatry” Oxford Press. 2005. p 230.