Delusional Disorder In Adults


ICD-10 code: F22

Delusional disorder is part of a cluster of diagnoses called the schizophrenia spectrum and other psychotic disorders. Schizophrenia spectrum and other psychotic disorders are a group of psychiatric conditions that include:

  • Schizophrenia
  • Schizoaffective Disorder
  • Delusional Disorder
  • Substance/Medication-Induced Psychotic Disorder
  • Psychotic Disorder Due to Another Medical Condition
  • Catatonia
  • Schizotypal (personality) disorders
  • Brief Psychotic Disorder
  • Schizophreniform Disorder

These disorders are characterized by symptoms that can be divided into two groups: positive and negative.

Positive symptoms include delusions, hallucinations, disorganized thinking (speech), and grossly disorganized or abnormal motor behavior (including catatonia). Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Hallucinations are perception-like experiences that occur without external stimulus. Disorganized thinking/speech is characterized by a derailment or loose associations in an individual’s speech pattern. Grossly disorganized or abnormal motor behavior is a difficulty in sustaining goal-oriented behavior. This may manifest itself in a variety of ways, ranging from childlike “silliness” to unpredictable agitation.

Negative symptoms include diminished emotional expression, avolition, alogia and anhedonia. Negative symptoms are those that involve a loss of normal function or experience. Diminished emotional expression is the reductions in the expression of emotions in the face, eye contact, intonation of speech, and movement of hand, head, and face that normally give an emotional emphasis to speech. Avolition is a decrease in motivated self-initiated purposeful movement. Alogia is manifested by diminished speech output. Anhedoia is the decreased ability to experience pleasure from positive stimuli.

What is Delusional Disorder?

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.

 

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Understanding Delusional Disorder in Adults

Although delusions might be a symptom of more common disorders, such as schizophrenia, delusional disorder itself is rather rare. The lifetime prevalence of Delusional Disorder is 0.2%, and the most frequent subtype is persecutory. Delusional disorder most often occurs in middle to late life and is slightly more common in women than in men. The jealous subtype, however, is more common among men.

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How is Delusional Disorder Treated?

Medications

Currently there is an overall lack of evidence-based information about the treatment of delusional disorder and insufficient evidence to make treatment recommendations. In the absence of such research, the treatment of delusional disorder typically consists of those that are considered effective for other psychotic disorders and mental health problems. Treatment usually includes a combination of antipsychotic medication with cognitive therapy or supportive therapy. 

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