Delusions & Delusional Disorder

Volume 2 Issues 8 August, 2021

Delusion is a false firm unshakable belief not keeping with the socio cultural background. They are among the most interesting of psychiatric symptoms because of the great variety. It has to be distinguished from superstition and overvalued ideas. In superstition the false belief is keeping with the sociocultural background whereas overvalued idea is a thought which is associated with feeling tone, takes precedence over all other ideas and maintains this precedence permanently or for a long period of time. Usually the delusions are described depending on the following: 1) According to fixity: Complete, partial. 2) According to onset: Primary and Secondary 3) According to theme (Content): Persecutory delusion, Delusion of reference, Delusions of grandiosity, Delusions of guilt or worthlessness, Nihilistic delusions, Hypochondrical, Somatic, Delusion of Jealous, Delusion of control 4) According To The Plausibility‐Bizzare, Non Bizzare 5)other delusional experiences: Delusional mood, Delusional perception, Delusional memory 5)Depending On Systematization: Systematized Or Non Systematized depending upon patients elaborate account about the single event or theme.

Delusional Disorder is best understood with an example

Mrs A aged 34 yrs hailing from rural background from eastern part of India belonging to middle socioeconomic status, working in BPO company, was brought to the hospital with complaint of being infested with a worm in head which was leading to tiredness & loss of weight. Non in her family believed it. For the above complaints patient was seen by many physicians, dermatologist and multiple investigations were done. All were within normal limit. Many tried educating her that complaints were irrational but yielded to pressure & prescribed multivitamins, antifungals, antibiotics, steroids etc but no improvement was seen in her symptoms, patient was then referred to the psychiatrist for the above complaints. After assessment, patient was started on low dose antipsychotics & the consequence of delusion‐related behaviour was addressed. She started showing response after 2 weeks.

Delusional disorder is a disorder of thought in which a person exhibits nonbizarre delusions that cannot be attributed to other psychiatric disorders, persisting for more than a month. It affects less than 0.5% of population and thought to be due to erroneous dysfunction of neurotransmitters in brain A careful history taking will lead to early detection and referral of such cases, may avoid unnecessary investigations, invasive procedures and financial burden.