Delusional Disorder and 7 common types of delusions

by Dr. Melissa Shepard, MD

by Dr. Melissa Shepard, MD

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Delusional Disorder is a rare diagnosis, affecting only 0.02% of the population. This disorder typically starts in late adolescence or early adulthood.

When people hear the word, “delusion” they often think of schizophrenia. While people with schizophrenia often do have delusions, they also experience other symptoms like hallucinations and abnormal thinking patterns. In contrast, people with Delusional Disorder do not have significant symptoms aside from their delusions.

There are seven subtypes of delusions that people can experience and some people may even experience two or more of these subtypes:

 
1. Erotomanic

The belief that a person is in love with them. Often the person has a higher status or is of great importance. Sometimes, people will try and make contact with these people.

 
2. Grandiose

Along with the belief of undiscovered talents, people may also believe themselves to be in positions that they are not, for example, a movie star or a political figure, a deity, or selected by a deity to accomplish something important. They may also believe that they are incredibly wealthy.

3. Persecutory

This is probably the most common subtype that people experience. The overarching theme can be paranoia and the belief that people are out to get them or keep them from accomplishing their goals.

 

illustration of woman sitting in the dark with hands reaching out behind her
4. Jealous

This is the belief that their partner is cheating on them with no evidence to support the delusion that their partner is unfaithful.

 
5. Somatic

This can be any delusion that is felt in or on the body. This can include the belief that they are very ill or they have a specific condition like cancer. Some people develop beliefs that they are pregnant, have insects or parasites in their bodies, or have something seriously wrong with their organs.

 
6. Mixed

This subtype means that the person is experiencing 2 or more subtypes from above.

 
7. Unspecified

This means that the delusions that someone is experiencing don’t fit neatly into any of the previous subtypes. For this type of delusion, someone might believe that outside events are related to them. An example of this could be the belief that an earthquake in another country was caused by their thinking or mood. Another example of unspecified delusions would be thought-broadcasting or the belief that others can hear their thoughts/or read their mind.

Delusions can be scary for those who have them as well as for the people who love them. When treating delusions, it’s important to look at the false belief and assess someone’s willingness to see it as a false belief (called “insight”). A therapist or doctor might look at how often the person is affected by the delusion(s) and how much time is spent thinking about it, as well as any changing behaviors based on their belief. A therapist or doctor might also look at a person’s commitment to the belief; for example, are they taking steps to get in touch with a person they believe to be in love with them. People with Delusional Disorders typically need medicines to treat their delusions. Psychotherapy, specifically CBT, can also be helpful in coping with and treating this disorder.

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