Delusional Disorders

A delusional disorder is a psychotic disorder characterized by delusional thinking, or an inability to determine reality from an imagined truth. This mental condition was previously labeled paranoid disorder due to the overly suspicious nature of common delusions. While this condition is often chronic, delusional disorder treatment is available and can greatly reduce the symptoms of delusional disorders. Learn more about the characteristics of this psychotic disorder and the delusional disorder treatment methods available.

Delusional Disorder

What Are Delusions?

Delusions are beliefs of false realities despite evidence that the belief is not true. People with delusional thoughts are not always poorly adjusted or unstable. Rather, they simply believe things that aren’t factual, or that are highly embellished. Examples of delusions include fears that are paranoid in nature, such as being poisoned or cheated on. Alternatively, a person with delusional thinking may believe things that support their ego, such as celebrities falling in love with them.

Delusional Disorder Criteria

A delusional disorder is a diagnosable disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DMS 5). Delusional disorder DSM-5 criteria are rather straightforward and include the presence of delusion(s) that persist for at least one month that can not be blamed on any other condition, such as substance abuse. Further, delusional disorder criteria explain that the person is not otherwise affected by the delusions. That is, they can carry out a somewhat otherwise ordinary life without noticeably strange behavior. This is not to say that relationships don’t suffer due to the delusions, just that most of life’s responsibilities can still be tended to.

The onset of this type of psychotic disorder is usually after age 40, and both men and women are affected by delusional disorders.

Types of Delusional Disorder

There are several types of delusional thinking. Overall, misbeliefs that could actually occur in real life, such as unfaithfulness, are titled non-bizarre delusions. Alternatively, bizarre delusions involve beliefs in unrealistic events (i.e., the belief in the ability to ride clouds). Obviously, a delusional disorder with bizarre delusions is much easier to detect and diagnose, while non-bizarre delusions may take some time to discover.

Delusional disorders are further categorized depending on the theme of the delusions. The types of delusional disorder include: 

Grandiose Delusion

A person with grandiose delusional disorder believes that they are of a much higher status than they are in reality. Examples of grandiose delusions include beliefs such as infinite personal wisdom, wealth, or power.

Erotomanic Delusion

Erotomanic delusional disorder is less common. It is characterized by the belief that someone, usually of importance, is in love with the person having delusions. Occasionally, this could lead to stalking or harassing behavior by the delusional person, even if they’ve never met the other person.

Jealous Delusion

Someone with jealous delusions generally believes that their significant other is having an affair.

Persecutory Delusion

Believing that someone is attempting to cause you harm or trying to spy on you would be persecutory delusions examples. People with persecutory delusions may even alert the police to their perceived danger.

Somatic Delusion

People with somatic delusions falsely believe that they have a debilitating medical condition. Alternatively, somatic delusion examples include people thinking they are physically deformed or infested with parasites.

Mixed Delusion

Those with mixed delusions experience more than one type of the delusions listed above.

Of all the types of delusions, persecutory delusion is thought to be the most common. Indications of persecutory delusions include aggressive or irritable behavior, usually due to the thought that someone is constantly trying to cause harm.

Delusional Disorder Symptoms

Delusional Disorder Symptoms

Specific delusional disorder symptoms will depend on the type of misbeliefs that a person is committed to believing. However, symptoms will generally act as an extension of the delusion. For example, these might include:

  • Hostile behavior towards those thought to be trying to cause harm
  • Professional problems associated with the preoccupation of the delusion
  • Tension in relationships due to steadfast belief in the delusion
  • General irritability or hostility

This vague and very personal nature of delusions is what makes diagnosing this type of disorder difficult. In general, a diagnosis can be made by a mental health professional if the delusional disorder DSM-5 criteria are met. The delusional disorder test is based on observation and self-reported beliefs which are then evaluated by a mental health practitioner. Additional evaluations may include lab tests and imaging in order to rule out any other conditions.

Delusional Disorder vs Schizophrenia

Delusional disorder is sometimes confused with schizophrenia, another psychotic disorder. While symptoms of both disorders may include believing things that aren’t true, delusional disorder is generally a more mild condition than schizophrenia.

For instance, a delusional disorder does not always cause a major disruption in a person’s life and can be manageable with various forms of therapy. Alternatively, schizophrenia can cause debilitating interruptions in a person’s ability to function in daily life and usually requires medication, at a minimum.

A few other differences between delusional disorder and schizophrenia include:

  • The severity of delusions.
    Oftentimes, people with delusional disorder may hold tight to beliefs that are not true but could actually happen in real life. This is in contrast to schizophrenic delusions, which are usually not plausible.
  • The Presence of Hallucinations.
    Symptoms of schizophrenia often include hallucinations, or seeing or hearing things that are not actually there, while a delusional disorder does not.
  • Impaired Verbal Communication.
    Those with schizophrenic disorder may have a hard time communicating verbally, while those with delusional order will not. 

Therefore, while there could be some overlap in symptoms between delusional disorders and schizophrenia, they are actually very different conditions.

What Causes Delusions?

The cause of delusional disorder is not known. However, researchers have outlined a few risk factors. In summary, these include:

  • A family history of delusions
  • High-stress environments
  • An imbalance in the brain

Other theories of the cause of delusions involve psychological conditions such as ego defensive mechanisms and responses to poor self-esteem.

Delusional Disorder Treatment

Delusional Disorder Treatment

Fortunately, delusional disorder is treatable. The most effective treatment for delusion disorders generally includes intensive psychotherapy. While medication for delusions may be helpful on a case-by-case basis, medication alone will not be as effective without the mental health counseling component. Ultimately, inpatient mental health treatment may be recommended if symptoms are severe or self-harm is a concern.

Inpatient Mental Health Treatment Near Cincinnati, Ohio

At the Georgetown Behavioral Hospital, we want you to know that you do not have to suffer from mental illness. If you or someone you know is showing signs of delusions, our mental health treatment team can help. Our inpatient behavioral health hospital offers a variety of counseling formats to suit each individual. Examples of these include:

Additionally, our Georgetown, Ohio location is convenient for residents of Cincinnati, Akron, Dayton, and Columbus in Ohio, as well as residents in neighboring states.

To learn more about our mental health program or get started on your recovery today, contact our admissions specialists at 937-483-4930 or use our confidential online contact form.



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