People with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, lasting for at least 1 month.
People with delusional disorder often can continue to socialize and function quite normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner.
Individuals with this condition typically exhibit at least one of five categories of delusions:
- Erotomanic delusions (beliefs that another person, generally of a higher social status, is in love with them)
- Grandiose delusions (beliefs that they have special status, power, or relationships)
- Jealous delusions (unsupported beliefs that sexual partners are being unfaithful)
- Persecutory delusions (beliefs that others intend them harm or are harming them)
- Somatic delusions (beliefs that the body has been changed or had parts replaced)
To be diagnosed with delusional disorder, these symptoms cannot occur exclusively alongside a mood episode. They also cannot be caused by drug or alcohol use.
Shared Delusion (Folie à deux) is a delusion that develops in someone who has a very close relationship with a delusional patient. The delusion is similar in content to that of the other close person’s established delusion.
Delusional disorder is relatively rare, has a later age of onset as compared to schizophrenia (the mean age is 40 years) and does not show a gender predominance. According to the DSM-V, the lifetime prevalence of the delusional disorder is about 0.02%. The prevalence of the delusional disorder is much rarer than other conditions; this may be in part due to underreporting, as those with delusional disorder may not seek mental health attention unless forced by family or friends.
The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person’s life circumstances, including the availability of support and a willingness to stick with treatment. Delusional disorder is typically a chronic condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission. Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a lifelong illness.
Treatment for delusional disorder most often includes medication and psychotherapy; delusional disorder is highly resistant to treatment with medication alone. People with severe symptoms or who are at risk of hurting themselves or others might need to be in the hospital until the condition is stabilized.
Psychotherapy is the primary treatment for delusional disorder. It provides a safe environment for clients to discuss their symptoms while encouraging healthier and more functional attitudes and behaviors. Psychosocial therapies commonly include individual psychotherapy to help the person recognize and correct the underlying thinking that has become distorted, as well as family therapy to teach families how to deal more effectively with a loved one who has delusional disorder, thus enabling them to contribute to a better outcome for the person.
Medications typically prescribed to treat the symptoms of delusional disorder are called anti-psychotics. Some clients may also require tranquilizers or antidepressants to alleviate concomitant symptoms of anxiety, restlessness or depression.
