Delusional disorder

Question 1

What is a delusion?

Answer 1

a fixed, false belief which is out of context for social and cultural belief

Question 2

What is the ICD-10 definition of delusional disorder?

Answer 2

A disorder characterised by the development either of a single delusion or a set of delusions that are usually persistent and sometimes lifelong. The content of the delusion or delusions are variable. Clear and persistent auditory hallucinations, schizophrenic symptoms such as delusions of control and marked blunting of affect, and definite evidence of brain disease are all compatible with this diagnosis. However, the presence of occasional or transitory auditory hallucinations, does not rule out this diagnosis.

Question 3

What are the different classifications of delusion?

Answer 3

monothematic
polythematic
primary
secondary

Question 4

What are monotheistic delusions?

Answer 4

delusions only relating to one particular topic

Question 5

What are polythematic delusions?

Answer 5

a range of delusional topics

Question 6

what are primary delusions?

Answer 6

occurs in the mind, fully formed and with no preceding reasons

Question 7

What are secondary delusions?

Answer 7

There is a preceding reasoning for the delusion e.g. depressed person feeling worthless

Question 8

What are the types of delusions and what do they mean?

Answer 8

• Delusional jealousy (Othello’s syndrome)  belief a person is being unfaithful
• Misidentification/Capgras’ delusion  belief that a close relative has been replaced by someone else who looks the same
• Persecutory delusion  belief that they are being spied on or planning to harm them
• Somatic/Hypochondriacal  belief that he/she has a physical defect/medical problem
• Grandiose delusion  exaggerated self-worth, believe they have powers, are the queen/king, related to famous people etc.
• Self-referential delusions  belief that something on TV/radio is talking to them/about them
• Nihilistic delusion  e.g. bowels rotted, already dead
• Religious delusion  more refers to the content of a delusion, all can contain religious reference
• Guilt delusion  responsibility for harm
• Delusional perception  describes a delusional belief resulting from a perception e.g. a traffic light turning red may be interpreted aby patient as defining moment when realised monitored by government

Question 9

Why can management be difficult for people with delusional disorder?

Answer 9

people not wanting to admit their beliefs are delusional or problematic, so will rarely seek out treatment.

Question 10

Psychopharmacological treatment?

Answer 10

antipsychotic medication

antidepressants e.g. SSRIs can be used for somatic delusions

Question 11

Psychotherapy treatment?

Answer 11

CBT
Patient education on psychiatric illness
support therapy - facilitate treatment adherence and education
minimise risk factors - sensory impairment, isolation, stress and precipitants of violence

Question 12

what are risk factors for delusional disorder

Answer 12

sensory impairment, isolation, stress and precipitants of violence