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Delusional Disorder: Causes, Types, Symptoms, Diagnosis And Treatment

Delusional disorder, formerly called paranoid psychosis, is a type of serious mental illness in which a person can't differentiate between reality and imagination. Simply put, a person has trouble in recognising reality and has a fixed false belief, despite clear evidence to the contrary [1].

Although delusional disorders are rare, it is more common among women. The lifetime prevalence of delusional disorders is estimated to be 0.02 per cent. Delusional disorders usually occur in older adults aged above 40 years, but it can affect people aged between 18 to 90 years [1], [2].

People with this disorder have one or more non-bizarre delusions, which means having a belief in certain situations that could happen in reality, although not true but are possible. These situations can be being followed, poisoned, conspired or deceived.

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What Causes Delusional Disorder?

The exact cause of delusional disorder is not known. However, various genetic, biological and environmental factors could cause it.


Types Of Delusional Disorders

Jealousy - A person with delusional disorder believes that his or her partner is unfaithful.

Erotomanic - A person is in a delusion that someone famous is in love with him or her.

Grandiose - A person believes that he or she has excessive self-worth, knowledge, power or identity and may believe that he or she has a great talent or has made an important discovery.

Persecutory - A person is in a delusion that he or she is being mistreated, harmed or attacked.

Bizarre - A person believes in a situation that is surreal that do not occur in real life.

Somatic - A person believes that he or she has a physical defect or a medical condition.

Mixed - A person with delusional disorder has two or more types of delusions.

Thought broadcasting - A person is in a delusion that others are aware of or can hear his or her thoughts.

Thought insertion - People with this disorder have a feeling that their thoughts are not theirs, but rather someone else's and have been inserted into their mind [3].

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Symptoms Of Delusional Disorder

• Irritable, angry or low mood.

• Hallucinations

• Non-bizarre thoughts


Complications Of Delusional Disorder

People with delusional disorder might become depressed, isolate themselves from others and acting on the delusions may cause violence or legal problems.


Diagnosis of Delusional Disorder

The doctor will conduct a physical examination and will ask about your medical history. There are no tests to specifically diagnose delusional disorder, but the doctor may perform an X-ray or blood tests to find out if there is any physical illness that is causing the symptoms.

If there is no physical illness, the doctor will refer the patient to a psychologist or psychiatrist. The psychiatrist will ask some questions and design assessment tools to assess a person for a delusional disorder.

The diagnosis of a delusional disorder is done when a person has one or more non-bizarre delusional thoughts for one month or more that are not linked with physiological, substance-induced, mental health condition or any medical condition [4].

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Treatment of Delusional Disorder

Delusional disorder is treated with medications and psychotherapy.

Medications [5]

Conventional antipsychotics, also called neuroleptics are used to treat and manage the symptoms of several psychiatric disorders.

In the 1950s, the first-generation antipsychotic medications were developed for the treatment of psychotic disorders. These first-generation antipsychotics were not tolerated properly and often had irreversible side effects and because of this, the second-generation of antipsychotics were developed in the 1980s. It was approved by the FDA to treat and manage psychotic disorders as well as bipolar disorder, schizophrenia, agitation, schizoaffective disorder and irritability.

Both first-generation and second-generation psychotic medications are available in oral and intramuscular injection forms.


Psychotherapy is also used to treat delusional disorders. These include individual psychotherapy, cognitive behavioural therapy (CBT) and family therapy.


Can Delusional Disorder Be Prevented?

Delusional disorder can't be prevented, but early diagnosis and treatment can help treat and manage the symptoms properly.

Common FAQs

Q. What is the most common type of delusion?

A. Persecutory delusion is the most common form of delusion.

Q. What are common delusions?

A. The common delusions are being followed, cheated, harassed, poisoned, attacked, spied on and conspired against.

Q. Does a delusional person know they are delusional?

A. No, because a delusional person can't tell what's real from what is imagined.

Q. How do you deal with someone who is delusional?

A. Pay attention to the emotions of the person, express that you are concerned and discuss that therapy is necessary.

Q. Do delusions ever go away?

A. Delusions can occur for a short period of time, however it may persist for months or years.