Delusional disorder

Question 1

What is a delusion? Is the patient aware that they are dilusional?

Answer 1

Fixed, false beliefs, held despite rational argument or evidence to the contrary. They are out of keeping with the person’s cultural or social background.

To the patient this is completely true and usually very important.

Question 2

What are the types of delusions?

Answer 2

Primary delusions - occur out of the blue

Secondary delusions - develop after another symptom e.g. hearing a voice, smelling something

Types of delusions:

• Persecutory (most common)
• Grandiose
• Nihilistic
• Hypochondriacal
• Of guilt
• Of reference
• Erotomania
• Of thought inference e,g, that someone is speaking to them from radio/TV

Question 3

How do you explore delusions?

Answer 3

Question 4

How do you test the strength of delusions? What is the most important thing to remember when doing this?

Answer 4

Needs to be done sensitively, asking as if you are curious

Question 5

Give some examples of sommon delusions.

Answer 5

Abusive towards neighbour e.g. “my neighbour is poisoning me”

Not leaving home, covering windown e.g. “MI5 are monitoring me”

Touching people on the train e.g. “I have healing powers and I will heal the world”

Not eating e.g. “My body is empty, my organs have been removed”