What Is a Delusional Disorder?

Paranoia, also known as delusional disorder, is a psychiatric diagnosis that refers to "having one or more non-grotesque delusions without the presence of any other psychotic symptoms." Patients with delusional disorder have no history of schizophrenia and no apparent hallucinations. However, depending on the specific type, tactile and olfactory hallucinations may occur. In spite of these hallucinations, people with delusional disorders are usually well-behaved and do not cause strange and bizarre behaviors.

Paranoia, also known as delusional disorder, is a psychiatric diagnosis that refers to "having one or more non-grotesque delusions without the presence of any other psychotic symptoms." Patients with delusional disorder have no history of schizophrenia and no apparent hallucinations. However, depending on the specific type, tactile and olfactory hallucinations may occur. In spite of these hallucinations, people with delusional disorders are usually well-behaved and do not cause strange and bizarre behaviors.

Paranoid classification

(1) Classification by delusional target

1. delusion of referemce

The patient considers things that have nothing to do with him to be related to him.

2. delusion of persecution

The patient firmly believed that people around him or some gangs followed him, attacked, framed him, and even poisoned his food and drinking water. Suspicious domination can include behaviors such as fasting, prosecution, running away, hurting people, and self-harm. More common in schizophrenia and paranoid psychosis.

3. delusion of specialsigificance

The patient believes that the words and deeds and daily actions of the people around him are not only related to him, but also have a special meaning.

4. delusion of physical influence

Patients believe that their thinking, emotions, and behavioral activities are dominated, controlled, and manipulated by some external force, and patients cannot be autonomous, saying that they affect delusions. If the patient believes that the external force that manipulates his mental activity is laser, X-ray, infrared, ultraviolet, etc. (all belong to physical factors) emitted by some advanced instrument, it is called physical influence delusion. More common in schizophrenia.

5. Exaggeration delusion (delusionofgrandeur)

Patients exaggerate their wealth, status, capabilities, rights, etc. It can be found in manic episodes of affective disorders, schizophrenia and cerebral organic disorders, such as paralytic dementia.

6. delusionofsin

Also known as sinful delusion. The patient baselessly believes that he has committed serious mistakes and crimes, or even that he is extremely guilty and deadly. He should be punished so much that he refuses to eat or asks labor reform to atone for the crime. It is mainly seen in depression episodes of emotional psychiatric disorders, but also in other mental illnesses such as schizophrenia.

7. Hypochondriacallydelusion

The patient has no basis to believe that he has a serious physical illness or incurable disease, so he seeks medical advice everywhere, even through a series of detailed examinations and repeated medical examinations and verifications can not correct his distorted beliefs, claiming a delusion of suspected disease. Serious paranoid delusions, the patient believes that "the internal organs have decayed" "I no longer exist, only one body is left", also known as nihilistic delusion. More common in schizophrenia, but also in menopausal and senile mental disorders.

8. delusionofjealousy

The patient was convinced that his spouse was unfaithful and had an affair. Therefore, patients follow their spouse's daily activities, and even check their spouse's underpants, etc., and try to find so-called evidence. More common in schizophrenia, alcoholism mental disorders, menopausal mental disorders and so on.

9. Feeling of being revealed inside (experience ofbeingrevealed)

Also known as insight. Patients think that their inner thoughts or the privacy of the patient and his family are known to others without the patient's words. Many patients do not know how and how others have learned his inner thoughts. As for the generation of insight, the following two situations are common: the first case is that although the patient firmly believes that the above idea is correct, he cannot tell how he has this idea, and on what basis he has this idea; The second case is different from the former case. The insights are based on other mental symptoms, and the patient's pathological reasoning is very judgmental. More common in schizophrenia.

10. erotomanictype

ErotomanicType is also called love delusion. Paranoia is a major manifestation of abnormal thinking. Paranoia is a distorted belief, pathological reasoning and judgment based on pathology. Most of these patients are at the age of 18 to 25, and are more common in women, but they can also occur in men. The premise of love delusion is that the patient first believes that he is in love, and the bite is that the other party falls in love with himself first.

11. Implies delusion

This delusion is special, and the patient will think of other people's actions about you with some hints. There are good and bad things that vary from person to person, so they often cause a lot of misunderstandings and cause other mental illnesses.

12. Other

Stolen delusions, beast delusions, non-blood delusions, etc.

(2) Classification according to the process of delusion

Primary delusion

The primary delusion is suddenly produced, and the content cannot be related to the situation and thinking at the time. It is a very obvious and unwavering delusional experience. It is not a perceptual disorder, nor a cognitive difficulty, nor is it an obstacle in the field of intelligence. Primary delusion contains three symptoms of delusion, delusional perception, and sudden delusion that are both interrelated and different from each other. Paranoid mood refers to the fact that the patient suddenly feels that the atmosphere and conditions of his environment have changed abnormally, is related to himself, and is threatening to himself. Primary delusions are more common in schizophrenia and have diagnostic significance for schizophrenia, so they have attracted much attention.

2. Secondary delusions

A secondary delusion is a delusion that develops on the basis of an existing psychological disorder. It is based on delusions, hallucinations, or emotional factors such as emotion, fear, depression, or emotional rise, or a desire (such as the prisoner s Desires). If the underlying psychological factors disappear, this delusion will also disappear. If the basis of the above-mentioned psychological activities is connected, the generation of delusions is understandable. The delusions of psychogenic paranoia, the delusions of depression and the exaggerated delusions of mania are secondary delusions.

Clinical manifestations of paranoia

1. The main obstacle is the lack of basic trust in people, which is characterized by the use of "negative effects" and "extrajection effects" to deal with their psychological difficulties, leading to a systematic delusional structure.

2. Sensitive and selfish, full of suspicion and aggressiveness for the purpose of self enjoyment.

3. Usually the problem is that you can't see the boundaries of yourself and you can't distinguish between yourself and others.

4. Many delusional patients do have some secrets that he personally thinks cannot be told. They are very guilty and afraid to know.

5. Lack of ability to recognize one's motivations and attitudes.

6. Lack of trust in others, always reported the concept of "others are always fierce enemies", and the impulse of self-aggression, so it has a bad relationship with others.

7. Some patients develop disease due to special circumstances, such as being in a different place.

8. In addition to personal factors, delusional content is also affected by social and cultural factors.

Paranoid Treatment

Drug treatment

Mainly antipsychotic drugs. The treatment of paranoia mainly depends on drugs, but for different types of paranoia, different treatment methods should be selected. Antipsychotics are one of the drugs of choice. If the patient is not cooperating, consider using long-acting injections of antipsychotics. Antidepressants can be used if the patient's mood fluctuates, including depression after psychosis.

Antipsychotic drugs are divided into western medicine and traditional Chinese medicine. In general, in order to fully recover from paranoia, traditional Chinese medicine and western medicine are needed, and professional psychological counseling is needed. Traditional Chinese medicine is represented by: Ginkgo biloba extract; Western medicine is represented by risperidone and sulpiride. The strength of western medicine is that it can work quickly, while the strength of traditional medicine is that it can repair damaged brain nerves and make patients heal from the roots.

2. Psychotherapy

The first step is to establish a good therapeutic relationship and change some behaviors by supporting the patient. In addition, patients should avoid excessive stress, which often affects the intensity of delusions in stressful situations, and teaches appropriate adaptation skills for individual cases, or cooperates with cognitive behavioral therapy, which can reduce the individual's inappropriate response to stress. If the patient agrees, their family should be encouraged to participate in the treatment plan, which will help the treatment progress.

3. Group therapy

Cooperate with the above treatment. Some patients can improve immediately, but others are more difficult to manage or last a lifetime. Without proper treatment, most patients can still maintain a relatively normal social life, but some patients cannot take care of themselves and the situation is serious.