Delusional disorder overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Delusional disorder is a psychiatric condition in which the patients present with delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis. Delusions can be bizarre or non-bizarre in content. Non-bizarre delusions are fixed false beliefs that involve situations that could potentially occur in real life; examples include being followed or poisoned. Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not generally seem odd or bizarre. However, the preoccupation with delusional ideas can be disruptive to their overall lives. For the diagnosis to be made, auditory and visual hallucinations cannot be prominent, though olfactory or tactile hallucinations related to the content of the delusion may be present. Delusions are false beliefs based on incorrect inference about external reality that persist despite the evidence to the contrary and these beliefs are not ordinarily accepted by other members of the person's culture or subculture. Nonbizarre delusions are about situations that could occur in real life, such as being followed, being loved, having an infection, and being deceived by one's spouse. Bizarre delusions are clearly implausible. Delusions that express a loss of control over mind or body are generally considered to be bizarre and include belief that one’s thoughts have been removed by an outside force, that alien thoughts have been put into one’s mind, or that one’s body or actions are being acted on or manipulated by an outside force.

Classification

According to the Diagnostic and Statistical Manual of Mental Disorders, delusional disorder may be classified into seven types based on content of delusions.

Pathophysiology

The exact pathogenesis of delusional disorder is not fully understood. It is thought that delusional disorder may be produced by polymorphisms in genes coding for dopamine receptors (DRD3 and DRD4).