2. TABLE OF CONTENTS
1. DEFINITION OF DELUSIONS
2. CAUSES OF DELUSIONS
3. STAGES/SEVERITY OF DELUSIONS
4. PRIMARY AND SECONDARY DELUSIONS
5. OTHER CLASSIFICATIONS OF DELUSIONS
6. CONTENT/THEMES OF DELUSIONS
7. TREATMENT OF DELUSIONS
3. WHAT IS A DELUSION
IT IS FALSE, FIXED, IDIOSYNCRATIC BELIEFS THAT PERSIST DESPITE EVIDENCE TO THE
CONTRARY AND ARE NOT TYPICAL OF A PATIENT’S CULTURE OR RELIGION
IT IS A THOUGHT DISORDER
A THOUGHT DISORDER (TD) IS ANY DISTURBANCE IN COGNITION THAT ADVERSELY
AFFECTS LANGUAGE AND THOUGHT CONTENT, AND THEREBY COMMUNICATION
TYPES OF THOUGHT DISORDERS
1. DISORDERS OF THE FORM OF THOUGHT-flight of ideas, thought blocking,
circumstantiality Tangentiality, loosening of associations.
2. DISORDERS OF THE CONTENT OF THOUGHT-True Delusions, delusion like ideas
over valued ideas
3. DISORDERS OF THE POSSESSION OF THOUGHT-Thought insertion withdrawal and
broadcasting
4. OTHER DEFINITIONS
KARL JASPER a psychiatrist and a philosopher was the first to define the 3 main criteria for a belief to be
considered delusional in his book General Psychopathology 1913 as follows
(1) Certainty, (Held with absolute conviction)
(2) Incorrigibility,(Not changeable by compelling counterargument)
(3) Impossibility or falsity of content( impausible, bizzare or patently untrue)
(HAMILTON 1978) & (SIMS 2003)& (FRANK FISH) - A delusion is false unshakeable belief which arises from
internal Morbid processes. It is easily recognizable when it is not keeping with the person’s educational and
cultural background
CTP 9TH EDITION (Comprehensive Textbook of Psychiatry)
DELUSION CAN BE DEFINED AS
1. FALSE BELIEF BASED ON INCORRECT INFERENCE ABOUT EXTERNAL REALITY
2. FIRMLY HELD DESPITE OBJECTIVE AND OBVIOUS CONTRADICTORY PROOF OR EVIDENCE
3. DESPITE THE FACT THAT OTHER MEMBERS OF THE CULTURE DO NO SHARE THE BELIEF
5. CAUSES OF DELUSIONS
This can be discussed by looking at the role of various genetic, biological, and environmental or
psychological factors.
• GENETIC: the fact that delusional disorder is more common in people who have family members
with delusional disorder or schizophrenia suggests that there might be a generic factor involved. It
is believed that, as with other mental disorders, a tendency to develop delusional disorder might be
passed on from parents to their children
. • BIOLOGICAL: researchers are studying how abnormalities of certain areas of the brain might be
involved in the development of delusional disorders. An imbalance of certain chemicals in the
brain, called neurotransmitters, also has been linked to the formation of delusional symptoms.
Neurotransmitters are substances that help nerve cells in the brain send messages to each other.
An imbalance in these chemicals can interfere with the transmission of messages, leading to
symptoms.
• ENVIRONMENTAL/PSYCHOLOGICAL: evidence suggests that delusional disorder can be triggered
by stress. • Alcohol and drug abuse: also might contribute to the condition. childhood abuse,
inability to establish mutual trust with others, pathological upbringing People who tend to be
isolated, such as immigrants low socioeconomic status or those with poor sight and hearing,
appear to be more vulnerable to developing delusional disorder.
6.
7. OTHER FACTORS CONCERNED WITH GENERATION OF
DELUSION
For Generation we have
1. Background influences of temperament and personality
2. Cognitive overload
3. Maintenance of Self esteem
4. Role of Affect/emotion
The theory of dysfunctional cognitive processing, which states that delusions may arise from
distorted ways people have of explaining life to themselves. A third theory is called
motivated or defensive delusions. This one states that some of those persons who are
predisposed might suffer the onset of delusional disorder in those moments when coping
with life and maintaining high self-esteem becomes a significant challenge. In this case, the
person views others as the cause of their personal difficulties in order to preserve a positive
self-view
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11. PRIMARY AND SECONDARY DELUSIONS
DELUSIONS CAN BE CLASSIFIED BASED ON ORIGINS CAN BE EITHER PRIMARY OR
SECONDARY
PRIMARY DELUSIONS: A delusion not occurring in response to another psychopathological form
based. Jaspers describes it as a true delusions, result of a primary delusional experience. The core
of Primary Delusion. It is rare and when it occurs it strongly suggest SCHIZOPHRENIA
SECONDARY DELUSIONS: Are delusion like ideas which can be derived from other morbid
psychological phenomena they can occur secondary to other psychopathological condition(
perceptual disturbances patient’s mood & personality Disorder)
they are understandable when a detailed psychiatric history and examination is available
for example an individual becomes depressed suffers low mood and self esteem and subsequently
believes they are responsible for some terrible crime which they did not commit.
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23. EXAMPLE
A person who works at a company may rigidly maintain the idea that he or she is the most valuable
member of the company, that he/she will save the company from ruin, or that he/she will soon be
made president of the company
Disorders with overvalued ideas are
1. Hypochondriasis,
2. Morbid jealousy seen in paranoid and borderline personality
3. Anorexia Nervosa
4. Body dysmorphic disorder
5. Gender Dysphoria (transsexualism)
24.
25. CONTENT OF DELUSIONS
1. DELUSION OF PERSECUTION
2. GRANDIOSE DELUSIONS
3. DELUSIONS OF JEALOUSY
4. DELUSIONS OF LOVE
5. DELUSIONS OF GUILT
6. DELUSIONS OF ILL HEALTH
7. SOMATIC DELUSIONS
8. NIHILISTIC DELUSIONS
9. DELUSIONS OF POVERTY
10. DELUSIONS OF CONTROL
11. RELIGIOUS DELUSIONS
12. DELUSIONS CONCERING POSESSION OF
THOUGHTS
13. MIXED DELUSIONS
14. UNSPECIFIED DELUSIONS
