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Of Minds and Delusions

Understanding the mind of the delusional

19767532_xxlPreviously known as paranoid disorder, delusional disorder is a type of serious mental illness involving psychosis – the inability to tell what is real from what is imagined. Delusional disorder’s main feature is the presence of delusions, or unshakable beliefs in something untrue. According to WebMD, people with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. Such delusions usually involve the misinterpretation of perceptions or experiences. However, in reality, the situations are either not true at all or highly exaggerated.

Unlike people with other psychotic disorders, people with delusional disorder often continue to socialise and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. Although in some cases, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.

While delusions could be a symptom of more common disorders such schizophrenia, delusional disorder in itself is a rare condition that most often occurs in middle to late life and is slightly more common in women than in men.

Types of Delusional Disorder

Based on the main theme of the delusions experienced by the individual, delusional disorder is classified into different types:

20341963_xlErotomanic: A type of delusional disorder wherein the individual believes that another person, often someone important or famous, is in love with him or her. The person suffering from this condition might attempt to contact the object of the delusion, most often by stalking them.

Grandiose: A type of delusional disorder wherein the individual has an over-inflated sense of self-worth, power, knowledge, or identity. In most cases, the person might believe he or she has a great talent or has made an important discovery.

Jealous: A type of delusional disorder wherein a person believes that his or her spouse or sexual partner is unfaithful.

Persecutory: A type of delusional disorder wherein people believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. People with this type of disorder commonly make repeated complaints to legal authorities.

Somatic: A type of delusional disorder wherein a person believes that he or she has a physical defect or medical problem.

Mixed: People with this type of delusional disorder have two or more of the types of delusions listed above.

Symptoms of Delusional Disorder

As opposed to schizophrenia, the organisation and form of thinking in delusional disorder is not impaired. Also, the mood symptoms such as depression are not prominent features in this condition. However, the most obvious symptom of delusional disorder is the presence of non-bizarre delusions. Other symptoms include hallucinations – seeing, hearing, or feeling things that are not really there, and are related to the delusion. For example, a person who believes he or she has an odour problem may smell a bad odour.

Causes of Delusional Disorder

Like many other psychotic disorders, the exact cause of delusional disorder is not yet known. Experts continue to study the role of various genetic and biological factors.

Genetic10069840_xl

The fact that delusional disorder is more common in people who have a family history or delusional disorder or schizophrenia suggests that there might be a genetic factor involved. Experts believe that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their children.

Biological

Researchers continue to study abnormalities of certain areas of the brain suspected to be involved in the development of delusional disorders. In particular, an imbalance of certain chemicals in the brain, called neurotransmitters, has been linked to the formation of delusional symptoms. Neurotransmitters, substances that help nerve cells in the brain send messages to each other, when present in imbalanced levels can interfere with the transmission of messages, thereby leading to symptoms.

Diagnosis and Treatment

People suffering from delusional disorder are not only difficult to diagnose, but are extremely difficult to treat. Firstly, there are no laboratory tests to specifically diagnose delusional disorder. On top of the routine complete medical history and physical exam, the doctor might use various diagnostic tests, such as blood tests or neuroimaging studies (i.e. brain MRI) to rule out physical illness as the cause of the symptoms. When no physical symptoms are detected, the doctor will refer the patients to a psychiatrist or psychologist – healthcare professionals who are specially trained to diagnose and treat mental illnesses. The treatment for delusional disorders most often includes medication and psychotherapy. As already mentioned, the treatment of this kind of disorder is extremely difficult. The patient needs a support system, most often family members (and close friends) who need to work closely with the mental health professional.

In Singapore, the Institute of Mental Health (www.imh.com.sg) and the Health Promotion Board (www.hpb.gov.sg) continue to spread out patient awareness on various mental health topics. Talk to your GP about mental health issues for proper referral.

Further Reading:

http://emedicine.medscape.com/article/292991-overview

http://www.mdguidelines.com/delusional-disorder

http://www.psychologytoday.com/conditions/delusional-disorder

http://www.webmd.com/schizophrenia/delusional-disorder

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Posted by ezyhealth on Feb 13 2014. Filed under Medical Section. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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