DELUSIONAL (PARANOID) DISORDER

Psychiatrists make a distinction between the milder paranoid personality disorder described above and the more debilitating delusional (paranoid) disorder. The hallmark of this disorder is the presence of a persistent, nonbizarre delusion without symptoms of any other mental disorder.

Delusions are firmly held beliefs that are untrue, not shared by others in the culture, and not easily modifiable. Five delusional themes are frequently seen in delusional disorder. In some individuals, more than one of them is present.


-- Ruth is a clerk typist who is efficient and helpful. Her employers and co-workers value her contribution to the office. But Ruth spends her evenings writing letters to State and Federal officials. She feels that God has opened her mind and given her the cure for cancer. She wants some leading treatment center to use her cure on all its patients so that the world can see she is right. Many of her letters go unanswered, or she receives noncommittal replies that only make her feel that no one understands that she can save all cancer patients if only given the chance. When one of her letters is answered by an employee of the official to whom she wrote, she is sure that the official is being deliberately kept unaware of her knowledge and power. Sometimes she despairs that the world will ever know how wonderful she is, but she doesn't give up. She just keeps writing. Ruth suffers from one of the delusional disorders, grandiose delusion.
The most common delusion in delusional disorder is that of persecution. While persons with paranoid personality might suspect their colleagues of joking at their expense, persons with delusional disorder may suspect others of participating in elaborate master plots to persecute them. They believe that they are being poisoned, drugged, spied upon, or are the targets of conspiracies to ruin their reputations or even to kill them. They sometimes engage in litigation in an attempt to redress imagined injustices.

Another theme seen frequently is that of delusional jealousy. Any sign--even a meaningless spot on clothing, or a short delay in arriving home--is summoned up as evidence that a spouse is being unfaithful.

Erotic delusions are based on the belief that one is romantically loved by another, usually someone of higher status or a well-known public figure. Individuals with erotic delusions often harass famous persons through numerous letters, telephone calls, visits, and stealthy surveillance.

Persons with grandiose delusions often feel that they have been endowed with special powers and that, if allowed to exercise these powers, they could cure diseases, banish poverty, ensure world peace,or perform other extraordinary feats.

Individuals with somatic delusions are convinced that there is something very wrong with their bodies--that they emit foul odors, have bugs crawling in or on their bodies, or are misshapen and ugly. Because of these delusions, they tend to avoid the society of other people and spend much time consulting physicians for their imagined condition.

Whether or not persons with delusional disorder are dangerous to others has not been systematically investigated, but clinical experience suggests that such persons are rarely homicidal. Delusional patients are commonly angry people, and thus they are perceived as threatening. In the rare instances when individuals with delusional disorder do become violent, their victims are usually people who unwittingly fit into their delusional scheme. The person in most danger from an individual with delusional disorder is a spouse or lover.
 

Page  1  |  2  |  3  |  4