Delusional Disorder

This condition is primarily characterized by the presence of ongoing non-bizarre delusions. The diagnostic criteria includes the following symptoms:

• Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration.

• Criterion A for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme.

• Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.

• If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.

• The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Subtypes

The type of Delusional Disorder may be specified based on the predominant delusional theme:

Erotomanic Type: delusions that another person, usually of higher status, is in love with the individual. Efforts to contact the object of the delusion (through telephone calls, letters, gifts, visits, and even surveillance and stalking) are common, although occasionally the person keeps the delusion secret.

Some individuals with this subtype, particularly males, come into conflict with the law in their efforts to pursue the object of their delusion or in a misguided effort to "rescue" him or her from some imagined danger.

Grandiose Type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.

Jealous Type: delusions that the individual's sexual partner is unfaithful.

Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.

Individuals with persecutory delusions are often resentful and angry and may resort to violence against those they believe are hurting them.

Somatic Type: delusions that the person has some physical defect or general medical condition.

Most common are the person's conviction that he or she emits a foul odor from the skin, mouth, rectum, or vagina; that there is an infestation of insects on or in the skin;

Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates.

Associated Features

Major Depressive Episodes probably occur in individuals with Delusional Disorder more frequently than in the general population. Delusional Disorder may be associated with Obsessive-Compulsive Disorder , Body Dysmorphic Disorder , and Paranoid, Schizoid, or Avoidant Personality Disorders .

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.