Delusions

Question 1

DSM-4

Answer 1

Delusion: false belief that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary

Question 2

Primary delusions

Answer 2

• Jaspers: primary delusions are the true, un-understandable beliefs that arrive fully formed and cannot be reduced further to any other mental experiences
• often precede other phenomena

Question 3

Autochthonous delusions

Answer 3

• delusional intuitions
• ideas that occur ‘out of the blue’
• Wernicke formulated this idea

Question 4

Delusional perception

Answer 4

• normally perceived object is given new meaning
• normal perecption precedes the attachment of delusional significance
• Schneider first rank

Question 5

Delusional mood

Answer 5

• refers to the sense of perplexity and uncertainty that exists during a prodrome of psychosis
• usually ends in an autochthonous delusion

Question 6

Delusional memory

Answer 6

• 2 types
• retrospectove delusion-something that never happened and so is false and bizarre
• or a normal memory might be delusionally elaborated
• sometimes a normal perception but recollected from memory with a false perception thereafter

Question 7

Persecutory delusions

Answer 7

-secondary delusions are often persecutory

Question 8

Paranoid delusions

Answer 8

• paranoid means ‘besides the mind’
• paranoid can only be used for self-referential delusions irrespective of their content
• includes grandiose delusions, persecutory delusions, referential delusions (cameras watching me), hypochondriacal or nihilistic delusion

Question 9

Monothematic delusions

Answer 9

• single delusions

e. g capgras, cotard, fregoli

Question 10

Capgras delusion

Answer 10

• doubles
• that is not my mum, it is a person who looks like her, imposter
• first reported by Kahlaum but described by Capgras
• mostly due to organic brain damage, schizophrenia or isolated delusional disorder

Question 11

Cotard delusion

Answer 11

• I am dead

Question 12

Fregoli delusion

Answer 12

• I am constantly being followed by people I know but I cant recognise them because they are always in disguise
• inverse to Capgras
• false identification of familiar people in strangers
• first reported by Courbon and Fail
• Fregoli is an italian mimic
• belief that the persecutor can invade the body of others
• rare

Question 13

Mirrored-self misindentification

Answer 13

-the person I see in the mirror isnt me it is someone who looks like me

Question 14

DE Clerambault’s delusion

Answer 14

• erotomania
• person X is secretly in love with me (usually a famous person who has never encouraged this idea)
• woman believes that an older man of higher social status is in love with her
• ‘Old maid’s’ insanity when persecutory beliefs coexist

Question 15

Othello syndrome

Answer 15

-pathological jealousy

Question 16

Morbid jealousy

Answer 16

• not a misidentification syndrome
• described by Ey
• common in alcoholics
• potential for violence

Question 17

Hypochanodriacal delusions

Answer 17

• typically seen in psychotic depression in the elderly
• part of Cotard’s
• Monosymptomatic hypochondriacal psychosis -described by Munro
• delusion of body odour= olfactory reference syndrome.
• Ekbom’s syndrome-delusional infestation
• dysmorphic delusions

Question 18

Syndrome of subjective doubles

Answer 18

-patient believes that another person has been physically transformed into his own self and that their exact doubles of himself

Question 19

Intermetamorphosis

Answer 19

• A becomes C, C becomes B etc
• people transforming their physical and psychological identities
• Courbon and Tusques
• very rare

Question 20

Paraprosopia

Answer 20

• very rare
• redescribed by Ellis
• a face appears to tranform into a grotesque mask
• mostly reported in schizophrenic children but also observed in adults

Question 21

Ideas of reference

Answer 21

• people take notice or observe him
• not seen in mania
• paranoid PD
• may procede development of full-blown schizophrenia

Question 22

Overvalued ideas

Answer 22

• Wernicke
• solitary abnormal beliefs that dominate a person’s life but neither delusional nor obsessional
• dominate subject’s life
• anorexia, body dysmorphia, morbid jealousy, transsexualism

Question 23

Folie a deux

Answer 23

• shared delusion in which psychotic person transfers his delusions to one or more people close to him
• the non-psychotic person usually exhibits dependent traits on the primary patient
• separation of the pair can result in remission

Question 24

Doppelganger

Answer 24

• awareness of oneself as being both outside and inside oneself
• cognitive and ideational disturbance
• can occur in the absence of mental illness
• not a delusional misidentification syndrome