A delusional disorder is a mental disease in which the affected person holds beliefs that are not real but they are just figment of imagination of the person. These untrue beliefs are considered and interpreted by the patient as real and he will not alter or modify it even when presented with real contradictory evidence. Many psychiatric illnesses have delusion as one of its symptom, but delusional disorder as a term is labeled only when delusion is the most prominent.
The possibility of actions or instances that a person notices or imagines when he is under delusion can occur in reality, but it is almost unlikely (for example he has delusion that his brother staying with him is planning to poison him, or has a delusion that he is being followed by someone etc).The delusions are generally of non bizarre type. In reality such thoughts or interpretations made by the patient are not true. In bizarre type, the thoughts a person is having cannot happen in reality.
Person with delusional disorder generally behaves normally with people in private and social gathering. But sometimes the person becomes so much occupied with his delusional ideas that he gets occupied with it throughout the day which can disrupt his daily routine. Delusion disorder is more common in female as compared to males. It usually develops in middle aged or older individuals.
What Are The Causes Of Delusional Disorder?
The exact etiology of delusional disorder is not known to researchers. Although they know that the disorder is a separate entity even if delusion is present in many other psychotic illnesses such as schizophrenia and other mood disorders. Delusional disorder is more common in people having some relative in the family suffering from schizophrenia. This suggests that there may be some type of genetic involvement which may increase the risk.
The condition is commonly observed in middle aged individuals or elderly persons. Delusional disorder is slightly more in females as compared to males.It is also commonly associated with other neurological conditions such as dementia, head trauma, and seizures. Neurological conditions which affect a certain part of brain called basal ganglia and temporal lobe have increased risk of associated delusion. Delusional disorder is also prominently seen in alcoholics and people undergoing severe mental stress. Persons with poor vision and hearing are usually vulnerable to develop delusion.
Types And Symptoms Of Delusional Disorder
The main clinical feature of delusional disorder is a fixed belief of something that is not real. It can be anything such as a situation or an action that does not occur in reality but at the same time there is possibility of such occurrence, hence it is termed as non bizarre. Delusional disorder is of many type and the symptoms may also differ. Here are different types of delusional disorder:
- Erotomanic: The patient is under fixed belief that he is in loving relationship with another person. This person is generally a famous personality. Such people are often found to be associated with stalking behavior.
- Jealous: In this type the person is jealous and suspicious that his wife/husband who is the sexual partner is unfaithful with him or her.
- Grandoise: This type of delusional disorder personality feel that he is someone very great. He thinks that has all the power or ability to manage any situation or has close relation with a prominent personality such as president, prime minister even though no such thing is present.
- Persecutory: In this type, the person has strong belief that someone is going to harm him, or he is being spied, or he is being mistreated by someone close to him or her. Because of this person often lodges complaint with legal authority repeatedly.
- Somatic: Patient with this type has false belief of an illness or physical defect. For example a person will have fixed belief that he is suffering from cancer even though all reports and medical investigations are negative.
Diagnosis And Treatment Of Delusional Disorder
Delusional disorder compared to other psychotic illness is a rare entity in itself, although delusion can be one of the symptoms of several mental and neurological illnesses. Because it is rare and often the thoughts are concealed by the patient, it becomes difficult to diagnose the condition. Normally the health care professional in such cases evaluates the patient’s medical condition. In some cases CT scan or MRI may help to detect neurological condition. Delusional disorder can be persistent in patient or may last for few months.
Treatment of delusional disorder has many hurdles because patient may not be cooperative, as he is convinced that whatever his thoughts and ideas are real even though they are not. Hence some patients think there is no need for any treatment. The difficulty is encountered more in patient having long standing delusional disorder.
Doctors usually prescribe antipsychotic treatment which in many cases is helpful. Sometimes patient may also need psychotherapy, especially if they refuse to take medicines. Reassurance and support from relatives and friend is crucial for patient to understand the reality from his unrealistic thoughts and beliefs. Hence patient’s relatives must be educated the way of handling him.