Psychological Disorders: Delusional Disorder
American
Description
A. 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.
B. 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.
Criterion A of Schizophrenia requires two (or more) of the following,
each present for a significant portion of time during a 1-month period
(or less if successfully treated):
delusions
hallucinations
disorganized speech (e.g., frequent derailment or incoherence)
grossly disorganized or catatonic behavior
negative symptoms, i.e., affective flattening, alogia, or avolition
Note: Criteria A of Schizophrenia requires only one symptom if delusions
are bizarre or hallucinations consist of a voice keeping up a running
commentary on the person's behavior or thoughts, or two or more voices
conversing with each other.
C. Apart from the impact of the delusion(s) or its ramifications,
functioning is not markedly impaired and behavior is not obviously
odd or bizarre.
D. If mood episodes have occurred concurrently with delusions, their
total duration has been brief relative to the duration of the delusional
periods.
E. 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.
Specify
type (the following types are assigned based on the predominant delusional
theme):
Erotomanic Type: delusions that another person, usually of higher
status, is in love with the individual
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
Somatic
Type: delusions that the person has some physical defect or general
medical condition
Mixed
Type: delusions characteristic of more than one of the above types
but no one theme predominates
Unspecified
Type
European
Description
This group of disorders is characterized by the development either
of a single delusion or of a set of related delusions which are usually
persistent and sometimes lifelong. The delusions are highly variable
in content. Often they are persecutory, hypochondriacal, or grandiose,
but they may be concerned with litigation or jealousy, or express
a conviction that the individual's body is misshapen, or that others
think that he or she smells or is homosexual. Other psychopathology
is characteristically absent, but depressive symptoms may be present
intermittently, and olfactory and tactile hallucinations may develop
in some cases. Clear and persistent auditory hallucinations (voices),
schizophrenic symptoms such as delusions of control and marked blunting
of affect, and definite evidence of brain disease are all incompatible
with this diagnosis. However, occasional or transitory auditory hallucinations,
particularly in elderly patients, do not rule out this diagnosis,
provided that they are not typically schizophrenic and form only a
small part of the overall clinical picture. Onset is commonly in middle
age but sometimes, particularly in the case of beliefs about having
a misshapen body, in early adult life. The content of the delusion,
and the timing of its emergence, can often be related to the individual's
life situation, e.g. persecutory delusions in members of minorities.
Apart form actions and attitudes directly related to the delusion
or delusional system, affect, speech, and behaviour are normal.
Diagnostic
Guidelines
Delusions constitute the most conspicuous or the only clinical characteristic.
They must be present for at least 3 months and be clearly personal
rather than subcultural. Depressive symptoms or even a full-blown
depressive episode may be present intermittently, provided that the
delusion persists at times when there is no disturbance of mood. There
must be no evidence of brain disease, no or only occasional auditory
hallucinations, and no history of schizophrenic symptoms (delusions
of control, thought broadcasting, etc.).
Includes:
* paranoia
* paranoid psychosis
* paranoid state
* paraphrenia (late)
* sensitiver Beziehungswahn
Excludes:
* paranoid personality disorder
* psychogenic paranoid psychosis
* paranoid reaction
* paranoid schizophrenia
