If the belief is acted upon, abnormal behavior may result which is out of character for the patient, but which may be understandable in light of the delusion the belief and behavior are felt to be uncharacteristic by those who know the patient.ĭelusional disorder is a primary disorder, with no medical or neurologic cause apparent. The patient is highly invested emotionally in the belief, and other elements of the psyche may be overwhelmed. The belief is nevertheless unlikely, and not in keeping with the patient’s social, cultural or religious background. The belief is central to the patient’s existence, and questioning it elicits an inappropriately strong emotional reaction. Delusional patients tend to be oversensitive and humorless, especially regarding the delusion. Despite profound conviction about the delusion, the patient is often secretive or suspicious in discussing it.
The patient expresses the delusional belief(s) with unusual force and persistence, and the belief or beliefs exert and inordinate effect on the patient’s life, often altering or dominating it. Munro identified 10 characteristics of delusions (Munro, 1999). Somatic delusions are associated with mood disorders and organic dementias, and may constitute their own diagnostic entity (body dysmorphic disorder) (Spitzer, 1990), while grandiose or persecutory delusions are often cardinal symptoms of schizophrenia and related disorders (Freeman, 2004). These include delusions of control, mind-reading, thought insertion, reference, persecution, grandeur, self-accusation, jealousy (Othello syndrome), romance or sexual involvement (erotomania), somatic change or disease or death (Cotard syndrome). Mood-neutral delusions are not related to the patient’s mood, such as having two heads or one arm.ĭelusions have a great variety of themes, but certain recurrent themes have been identified (Spitzer, 1990). Mood-congruent delusions are false beliefs that are consistent with the patient’s mood if disordered, such as power and influence with mania and rejection and ostracism with depression. Bizarre delusions are strange and implausible, such as being vivisected by aliens, while non-bizarre delusions are possible but unlikely, such as being under surveillance. Symptoms of Delusional Disorderĭelusions are generally categorized in 4 groups: bizarre, non-bizarre, mood-congruent and mood-neutral. Delusions are associated with a variety of mental and neurological disorders, but are of diagnostic importance in the psychotic disorders. The psychiatrist and philosopher Karl Jaspers proposed 3 criteria for delusional beliefs in 1913: certainty (the belief is held with absolute conviction), incorrigibility (the belief cannot be changed with any proof to the contrary) and impossibility or falsity (the belief cannot be true) (Jaspers, 1967). It is distinct from an erroneous belief caused by incomplete information (misconception or misunderstanding), deficient memory (confabulation) or incorrect perception (illusion).
Morbid jealousy syndrome manual#
There have been some changes in diagnostic criteria for this condition in the new edition of the Diagnostic and Statistical Manual of Mental Disorders, intended to improve the reliability and stability of the diagnosis and facilitate consistent treatment (American Psychiatric Association, 2013).Ī delusion is a belief that is held with strong conviction despite evidence disproving it that is stronger than any evidence supporting it. DSM-5 Category: Schizophrenia Spectrum and Other Psychotic Disorders Introductionĭelusional disorder is one of the less common psychotic disorders, in which patients have delusions but not the other classical symptoms of schizophrenia (thought disorder, hallucinations, mood disturbance or flat affect).
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