Delusional Disorder: The 7 Subtypes That Exist And Their Main Treatment
What is delusional disorder and what types exist? What treatments are there? Discover its symptoms and the most effective interventions for this disorder.
Delusional disorder has an important relationship with schizophrenia and schizotypal personality disorder. Although the course of the disorder is stable, a percentage of people who suffer from it will end up developing schizophrenia. In this sense, it has been observed that those people who have family members with schizophrenia or schizotypal personality disorder are more likely to end up developing a delusional disorder.
It is estimated that 0.2% of the population suffers from this disorder, the subtype being persecutory the most frequent. Although there are no differences between genders, it has been found that there are more men with the subtype jealousy what women Although it may seem that people who have this disorder have a great impact on their daily lives, the reality is that they usually perform well in their daily lives except in areas related to delirium.
Delusional disorder is a disorder included in the category of schizophrenia spectrum disorders and other psychotic disorders of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). This disorder is characterized by the presence of one or more delusions that can be different depending on the person who suffers from it. But… What is a delirium? A delusion is a belief that the person considers valid without having any objective evidence, only the thought itself. Therefore, they are usually failures in the interpretation of a stimulus that really exists and sometimes, they are beliefs about aspects that could occur in reality, such as, for example, infidelity in the case of jealousy delusions. In fact, in the case of delusional disorder, these delusions are characterized because they are not strange ideas but rather could occur in reality.
They are commonly confused hallucinations and delusions and although they may be present in the same clinical picture, the reality is that they are different concepts. Hallucination involves perceiving through the senses (vision, hearing, smell, etc.) something that does not really exist in the environment but is conceived as real. On the other hand, in delusions a stimulus that really does exist in outer space is misinterpreted.
What criteria must be met?
According to the DSM-5, to meet the diagnosis, one or more delusions must be present for a month or more in duration and the following criteria must be met:
The person has never met the symptoms of schizophrenia. If the person has hallucinations, they must be related to the delusional belief. For example, a person with delusional disorder with somatic subtype who believes that his or her body is breaking down might have olfactory hallucinations.
The person does not have significant interference in their daily functioning in areas that are not related to the delirium. For example, a person who suffers from delusional disorder of the jealous subtype will present problems in the relationship but not in the workplace.
If episodes of depression or manic episodes (a state of great excitement and activation considered outside of “normal”) have occurred, they should not be greater than the episodes in which delusions have occurred.
Delusions are not related to drug use, medications and/or a medical illness.
What types of delusions can occur in this disorder?
According to the DSM-5, this disorder has different variants depending on its characteristics. When it does not fit any specific type or shares characteristics of different subtypes, it is diagnosed as a mixed type or unspecified type. The other 5 variants are:
Erotomaniac (or Clerambault): The central theme of delirium focuses on the person having the conviction that someone is in love with him or her. Often the person in love is someone famous or with a higher status. Sometimes, they may present legal problems because their belief leads them to situations of harassment or conflicts of persecution, searches, etc.
Of greatness (or megalomaniac): He megalomaniacal delirium or greatness is characterized because the person believes that he or she has a specific talent or knowledge that is not recognized by others or that he or she has made discoveries that he or she has not really made. For example, a person with this subtype may believe that he is an important writer and that he has written works that he really did not write.
Jealousy: The person believes that their partner is being unfaithful even though there is no indication that this is the case. As in the case of erotomanic delusion, people who present the jealous subtype may have problems with the law since they may sometimes physically attack their partner because of the beliefs they present.
Persecutory: Those who suffer from this subtype believe that they are victims of a conspiracy against them. They may believe that there is someone who wants to poison them, drug them, deceive them, scam them, follow them, harass them, etc. Therefore, they have great distrust and suspicion towards the movements and intentions of others.
Somatic: The delusional idea It is focused on bodily sensations. The person may firmly believe that his or her body smells bad, that it is decomposing, etc. Therefore, the person believes that he has an illness and/or a physical defect that he does not really present and that no one can perceive.
The treatment of delusional disorder is usually complicated since people who suffer from it are not aware of having a problem, for them it is real, and therefore not only do they not seek but they reject treatment. However, various studies have shown that 50% of people who receive treatment present a complete improvement of the disorder, 20% a decrease in symptoms and 30% do not present any change. This indicates that although there are treatments that have been shown to be more effective than others, research is still necessary to find those interventions that are effective for delusional disorder and for all psychotic disorders in general. Despite the above, it has been proven that delusional disorder has a good prognosis when treated early. Treatment is usually based on:
Psychological treatment: The therapies that have proven to be most effective for the treatment of delusional disorder are those of the cognitive-behavioral approach. In general terms, this type of therapy focuses on making the person aware of the relationship between thought, emotions and behavior, helping them to look for evidence that confirms or denies the delusional idea they present. Some of these therapies also start from the normalization of delusional experiences with the aim of reducing stigma and helping to rationally explain both the disorder and the triggers (those factors prior to the presentation of the disorder).
Psychopharmacological treatment: The drugs that have proven to be most effective for the treatment of delusional disorder in general are antipsychotics and antidepressants. In the event that the person has a somatic subtype, the type of psychotropic drugs that have proven to be most effective are antipsychotics.
It is difficult for people who have delusional disorder to seek help on their own. If you think there is someone in your environment who can fulfill the above, it is important that you seek the help of a mental health professional with the aim of being able to intervene and improve both the symptoms and your mental well-being.
