Delusions are incorrect judgements that patients experiencing them strongly believe to be true. This symptom can occur as a stand-alone problem, but also in the course of a large number of different disease entities. The content of delusions can be very varied: they can refer to being persecuted, to believing oneself to have an important function in society or to someone sending one's thoughts to the patient.
Table of contents:
- What are delusions?
- The most common type of delusion
- Other types of delusions - a breakdown by their content
- Delusions in the course of affective disorders
- "Contagious" delusions
- Other classification of delusions
What are delusions?
In psychopathology, delusions are classified as disorders of the content of thought. To be able to speak of their occurrence, the following criteria must be met:
- the patient's beliefs are strongly contrary to reality,
- the patient firmly believes in his judgements and all attempts to rationally dissuade him from them are impossible.
Delusions may appear in the course of a considerable number of disease entities. They may accompany affective disorders (such as depression or bipolar affective disorder) or appear in patients with schizophrenia. The problem may also be associated with psychoactive substance addictions and organic mental disorders (such as stroke or Alzheimer's disease).
Arguably, both because of the multitude of conditions in which delusions can occur and because of the capacity of human thinking, false illness judgements can involve a huge number of aspects. The reason for this is that some delusions can easily be classified as a mental dysfunction. For others, on the other hand, the doctor has to think carefully about whether they are really caused by the illness or whether, even when the patient's beliefs seem quite absurd, they are nevertheless true.
The most common type of delusions
Persecutory delusions are considered to be the most common. Patients are convinced that someone is following them or trying to do them harm. With this type of delusion, patients may, for example, refuse to eat because of the fear of receiving poison in their food. The psychiatrist who treats a patient with delusions of persecution must take into account the fact that he or she may also be among those suspected of wanting to harm the patient, a situation that makes it very difficult to reach a therapeutic agreement between the patient and the doctor.
Other types of delusions - a breakdown by their content
Patients with delusions of grandeur express a belief in their own uniqueness or that they have significant connections. Patients may claim to be particularly important people (e.g. rulers of the world). Interestingly, some patients try to emphasise their uniqueness (e.g. by flamboyant, distinctive dressing), while others do not distinguish themselves in appearance from the average person.
A delusional patient may claim that their behaviour or even their whole life is controlled by some external force - this is the case with delusions of possession. A similar type of problem is the delusions of thought imposition or thought deception, when the patient - respectively - has the feeling that the thoughts in his head come from some external source or when the patient claims that some force removes the thoughts from his head.
Relational (xobic) delusions are said to occur when the patient claims that the world is focused too much on them. For example, the patient may be convinced that all the laughing people around him are mocking him or claim that all the conversations of strangers are focused on him.
Delusions of jealousy are associated with the constant belief that the patient's partner is unfaithful to him. Their existence can lead to attempts to constantly monitor the loved one, which may even end in attempts to constantly monitor the partner's life (e.g. by hiring a detective).
Erotic delusions, on the other hand, refer to situations in which the patient is convinced that a stranger is in love with him or her (usually this person holds an important social position or is particularly popular).
The patient may also have the impression that his or her body is not functioning properly - such a situation occurs in the case of somatic (hypochondriacal) delusions. The existence of such judgements can cause the patient to visit the offices of more medical specialists over and over again in order to explain their existing complaints. Within somatic delusions, the so-called Ekbom syndrome is sometimes mentioned, i.e. a belief in the presence of some creatures (e.g. worms) under the surface of the skin.
People with delusions may also misidentify other people. In the so-called Capgras syndrome, the patient seems to think that some close person has been replaced by a double. In the so-called Fragoli syndrome, on the other hand, the patient claims that some unknown people have changed their superficiality in order to start resembling his relatives.
Delusions in the course of affective disorders
In the course of depressive episodes, patients may experience nihilistic delusions (e.g. feeling that the world has ended), or delusions of singleness or guilt. Delusions of grandiosity, already mentioned, may in turn co-occur with episodes of mania.
Delusions, photo: shutterstock
"Contagious" delusions
In the case of what is known as ' granted insanity ' (also referred to as folie a deux), incorrect beliefs develop in two people. Induced delusional disorder usually occurs in people who are in some sort of isolation and are linked by a close emotional relationship. The delusions originally experienced by one patient begin to occur in the next person over time. Usually the content of the maladaptive beliefs in both affected individuals is similar.
Another classification of delusions
Delusions can be congruent or incongruent with mood. The first situation applies, for example, to depressed patients with guilt or nihilistic delusions. Delusions incompatible with mood, on the other hand, can be considered grandiose judgements in a patient with depressed mood.
Systematic del usions are various types of beliefs that can somehow be logically related to each other. Non-systemised delusions, on the other hand, are the kind of judgements where it is difficult to find any direct link between them.