Delusional disorder is a rare psychiatric diagnosis represented by the occurrence of non-bizarre delusions in the absence of other moon or psychotic symptoms. Individuals with this order do not experience visual hallucinations or hear voices as is the case in schizophrenia. They may, however, experience touch or smell hallucinations relating to their delusion.
Persons with delusional disorder may be seem quite functional in daily life as they do not display odd behavior except as it relates to their delusional beliefs. Although the delusion may not effect their personality, over time they may become more involved or obsessed with it to the extent that they can not determine whether something is real or imagined.
Delusional disorder was previously referred to in the mental health field as “paranoia” or “paranoid disorder”. Current references to “paranoia”, however, are not related to this disorder.
Symptoms of this disorder appear as a unshakable belief that something is true. The delusion is generally something that could happen in real life. The individual with delusional disorder, however, holds this belief with a forceful persistence that exhibits an unhealthy influence on their life. Their life is altered to a large extent by the delusional belief.
When confronted regarding their delusion, a person with this disorder becomes secretive or suspicious and has no humor regarding their belief. Questioning of their reasoning tends to arouse strong reactions, irritability and hostility to the person posing such doubt.
The delusion often leads to abnormal behavior or actions that are out of character for the individual. These actions are, however, reasonable when considering the theme of the delusion. The delusion does not usually interfere with the individual's general logical reasoning. Because of the nature of their delusions, some individuals may experience legal problems and become alienated from others, resulting in depression. Relationships with family members are often turbulent.
Delusional disorder can appear in several different forms. Erotomanic delusions are beliefs that another person, generally of higher status, is in love with the individual and may include stalking behaviors or attempts to contact the subject of the delusion. Grandiose delusions are beliefs that the individual has inflated worth, knowledge, or power, and may include believes that the individual has enhanced talent or has created something important. Jealous delusions are beliefs that the individual's spouse or sexual partner is being unfaithful. Persecutory delusions foster beliefs that the individual or someone close to them is being mistreated, is in danger, or is being spied on and may include repeated complaints to law enforcement authorities. Somotic delusions are beliefs that the individual has a physical defect or medical condition. In some cases, the individual with delusional disorder may have delusions that encompass several of the types listed.
This disorder generally appears in mid to late life and is more common in women. The cause is not know, but there appears to sometimes be genetic, biological, environmental and/or psychological factors. It is more prevalent in persons who have family members with the disorder or with schizophrenia. The tendency appears to be passed from parent to child and may related to abnormalities in certain areas of the brain or chemical imbalances. It can often be triggered by stress, alcohol and/or drug abuse, or isolation.
Treatment for the disorder consists of medication and psychotherapy. It is highly resistant to treatment with drugs alone. Under proper supervision, individuals can learn to control their symptoms, identify possible relapses in the disorder, and to develop plans for prevention of relapses.
