Delusional disorder facts for kids

Kids Encyclopedia Facts

Quick facts for kids Delusional disorder
Synonyms	Paranoid disorder, delusional insanity

A painting showing an old man with a strong belief of having great power. This kind of belief is common in delusional disorder.
Symptoms	Strong false belief(s) despite superior evidence to the contrary
Usual onset	Usually around age 40 (can be 18–90)
Types	Erotomanic type, grandiose type, jealous type, persecutory type, somatic type, mixed type, unspecified type
Causes	Genetic and environmental
Risk factors	Family history, chronic stress, low income
Similar conditions	Paranoid personality disorder, schizophrenia, bipolar disorder, substance-induced psychosis
Frequency	estimated 0.3% of general population

Delusional disorder is a type of mental illness where a person has very strong beliefs that are not true. These strong false beliefs are called delusions. People with this disorder usually do not have other major symptoms like seeing or hearing things that aren't there (hallucinations), confused thinking, or extreme changes in mood.

Delusions can be about things that are very strange (bizarre), like believing aliens are controlling your thoughts. Or they can be about things that could happen in real life (non-bizarre), such as believing someone is trying to harm you or poison you.

Even with these strong false beliefs, people with delusional disorder can often live normal lives. They might still go to school or work and spend time with friends. Their behavior might not seem strange to others. However, thinking about their delusions all the time can make their lives difficult.

For a doctor to diagnose this condition, the person's false beliefs cannot be caused by medicines or other health problems. Also, someone who has already been diagnosed with schizophrenia cannot also be diagnosed with delusional disorder. People with delusional disorder can often do well in their daily activities.

Doctors and psychologists agree that when looking at a person's beliefs, it's important to understand their culture and religion. What might seem like a false belief in one culture could be a normal belief in another.

Types of Delusional Disorder
How to Recognize Delusions
What Causes Delusional Disorder?
How Doctors Diagnose It
How Delusional Disorder is Treated
How Common is Delusional Disorder?
Challenges in Diagnosis
See also

Types of Delusional Disorder

Doctors classify delusional disorder into different types based on what the person's false beliefs are about. The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists several types:

Grandiose type: A person believes they have special talents, great power, or are a very famous person. They might think the real famous person is an impostor.
Persecutory type: This is a common type. The person believes they are being spied on, harmed, or unfairly treated in some way. They might try to get "justice" by reporting people or taking action.
Somatic type: The person believes they have a serious physical problem or a medical condition, even when doctors say they don't.
Mixed type: This type includes false beliefs from more than one of the types listed above, but no single type is the main one.
Unspecified type: This is when the false beliefs don't clearly fit into any of the other specific types.

How to Recognize Delusions

It can be hard to tell if someone has a delusion. Here are some signs that might suggest a person has a delusion:

A person talks about an idea or belief very strongly, even when there is clear proof that it's not true.
This idea seems to control a big part of the person's life, and their daily routines might change in strange ways because of it.
Even though they are very sure about their belief, they might act secretive or suspicious when asked about it.
The person might not find humor in their belief and can be very sensitive about it.
They accept strange things happening to them without question, no matter how unlikely they seem.
If someone tries to tell them their belief is wrong, they might get very upset, irritable, or even hostile. They won't accept other ideas.
The belief is very unlikely and doesn't fit with the person's social, cultural, or religious background.
The person is very focused on this idea, and it seems to take over their thoughts.
If they act on their false belief, their behavior might seem unusual or out of character for them.
Other people who know the person well notice that the belief and behavior are not typical for them.

People with delusional disorder often have these additional features:

It is a main mental health condition.
The false beliefs are very strong, and the person holds onto them tightly.
The condition is often long-lasting, sometimes for life.
The false beliefs often seem logical and consistent within their own system, even if they are not true.
The person's general thinking skills are usually fine, but their logic is twisted when it comes to their false beliefs. Their behavior is usually normal unless it's directly related to their delusions.
The person feels that everyday events are very important to them, even if others don't see them that way.

What Causes Delusional Disorder?

Doctors don't know the exact cause of delusional disorder. However, several things might play a role:

Genetics: It might run in families, meaning if someone in your family has it, you might be at a higher risk.
Brain Chemistry: Some people with delusional disorders might have an imbalance in brain chemicals called neurotransmitters. These chemicals help send messages in the brain.
Environment: Things like high stress or having a low income might also increase the risk.

Delusional disorder is thought to be related to schizophrenia, but people with delusional disorder generally have fewer symptoms and can function better in daily life.

How Doctors Diagnose It

To diagnose delusional disorder, doctors first rule out other health problems like dementia, infections, or other medical conditions. Then, they rule out other mental health conditions. In delusional disorder, mood changes are usually short or not present. Also, unlike schizophrenia, the false beliefs are usually about things that could happen in real life, and hallucinations (seeing or hearing things that aren't there) are minimal or absent.

Doctors use interviews to learn about the patient's life and history. They also review past medical records. Talking to the patient's immediate family can be very helpful to find out if delusions are present. Doctors also do a mental status examination to check the patient's current mental state.

When diagnosing a non-bizarre delusion, doctors try to check the facts. For example, if someone believes their partner is cheating, doctors would try to see if there's any real evidence. However, if the person still believes it strongly even after facts prove it's not true, it's considered a delusion.

How Delusional Disorder is Treated

One challenge in treating delusional disorder is that most patients don't realize they have a problem. Most people are treated as out-patients, meaning they don't stay in a hospital. However, if there's a risk of harm to themselves or others, they might need to go to the hospital.

Individual Therapy: One-on-one talk therapy is often recommended instead of group therapy, because people with delusional disorder can be very suspicious of others.
Medication: Medicines called antipsychotics are not fully tested for delusional disorder. They don't always help with the main false belief. However, they can be useful for managing agitation or restlessness that might come with the disorder.
Cognitive Therapy: This type of therapy helps people understand and change their thinking patterns. A therapist might ask questions to help the person think differently about their false beliefs. This therapy has been studied mostly for people with the persecutory type of delusion.
Supportive Therapy: This therapy helps patients stick to their treatment plan and learn more about their condition.
Social Skills Training: Learning social skills can help people feel more comfortable and confident when interacting with others, especially those they might see as a threat.

How Common is Delusional Disorder?

Delusional disorder is not very common. It's estimated that about 24 to 30 out of every 100,000 people have this condition. About 0.7 to 3 new cases per 100,000 people are reported each year.

This disorder usually appears in middle to late adult life, often between the ages of 33 and 55. It is more common in women than in men. People who have moved from one country to another (immigrants) also seem to be at a higher risk.

Challenges in Diagnosis

Sometimes, a belief that seems like a delusion might actually turn out to be true. For example, if someone believes their partner is cheating, and it turns out to be true, it doesn't mean it wasn't a delusion before it was confirmed.

Also, doctors might sometimes mistakenly think a belief is false just because it seems unlikely or strange to them. Doctors don't always have the time or resources to check every claim a person makes. This can lead to true beliefs being wrongly called delusions. This situation is sometimes called the Martha Mitchell effect. Martha Mitchell was a woman who claimed illegal things were happening in the White House, and at first, people thought she was mentally ill. Later, during the Watergate scandal, her claims were proven true.

These challenges show that it can be hard to define what a delusion truly is. Some experts even say there isn't one perfect definition of a delusion.