Symptoms of delusional disorder
Delusional disorder can develop in the context of an existing paranoid personality disorder. In such people, constant distrust and suspicion of others and their motivations begin in early adulthood and persist throughout life. Early symptoms may include a feeling that the patient is exploited, a concern for the loyalty and creditworthiness of friends, a tendency to see threatening meanings in minor statements or events, constant discontent and a willingness to respond to neglect.
There are several types of delusional disorder. In the erotomanic version, the patient believes that another person is in love with him. There are often attempts to contact delusional objects through phone calls, letters, surveillance or harassment. People with this version of the disorder may have conflicts with the law because of their behavior. In the variant with ideas of greatness, the patient believes that he is talented or that he made an important discovery. In the variant with ideas of jealousy, the patient thinks that the spouse or loved one is cheating on him. These ideas are based on incorrect reasoning, based on questionable evidence. A significant danger can be a threat of physical attack. In the variant with persecution ideas, the patient believes that surveillance is organized against him, he is harmed and plagued. The patient can make repeated attempts to achieve justice by appealing to the court and other government structures, as well as resorting to violence as retribution for the alleged persecution. In the somatic version, delusional ideas are associated with bodily functioning, i. E. The patient believes that he has a physical defect, parasites or from it emits a smell.
The diagnosis largely depends on the conduct of clinical evaluation, obtaining detailed anamnestic information and excluding other specific conditions accompanied by delirium. It is extremely important to assess the danger, especially the extent to which the patient is willing to act in accordance with his delusional ideas.
Delusional disorder associated with passion: pathological jealousy and erotomania
This group of disorders is comprehensively examined by Mullen. The core of persuasion in case of morbid jealousy is formed by the submission of the subject about infidelity to him / her. This idea dominates thinking and acting and reaches a pathological level. Jealousy - a normal phenomenon, and its adoption in society is partly due to the entocultural characteristics of the population. Mullen assumes that there is a continuum from the degree of profound conviction in normal persons - to supervalued ideas and further - to delusional ideas, characteristic both for morbid jealousy and for erotomania. In studies of women victims of domestic violence, it has been established that the jealous partner is an important cause of violence. Usually, it is partners who suffer from attacks, while imaginary rivals are rarely victims. According to modern ideas, in addition to physical assault, partners of persons suffering from pathological jealousy may experience severe psychological distress, including post-traumatic stress disorder.
Erotomania is characterized by a painful conviction of falling in love with another person. Mullen offers three main criteria:
- The belief that love is mutual, in spite of the fact that the alleged "lover" does not show it in any way.
- Propensity to reinterpret words and actions of the object of attention in order to maintain the existing belief.
- Load of supposed love, which becomes the center of existence of the subject.
And the subject does not need to consider that his love is mutual (painful love for insanity). Like morbid jealousy, erotomania can act as part of another disorder, usually schizophrenia and mood disorders. The difference between subjects suffering from schizophrenia from cases of "pure" erotomania is that the object of their love or passion can change over time, as well as the presence of a more pronounced sexual element. Objects of attention erotomanov usually from their immediate surroundings, although the media like to talk about cases with famous persons, movie stars, etc. There is a great chance of becoming a victim of erotomania among doctors, including psychiatrists, who are engaged in helping vulnerable people.
According to Mullen, erotomanic disorders are almost inevitably accompanied by stalking, that is, persecution. Stalking involves a determined attempt to enter into contact or to engage in communication with the object of attention of the stalker. If the attempt of contact fails or encounters resistance, then threats, insults, intimidation - either by direct contact or by means of communication (by mail, by phone, etc.) follow. Menzies et al. Reports of frank sexual intimidation or attacks in a group of male erotomaniacs studied. Both Mullen & Pathe and Menzies et al. Note the high levels of threats and attacks among the stalkers they studied, although both populations were judicial, that is, with a preponderance of the actual risk of attack. Victims of stalking can suffer hard from repeated and unpredictable interventions in their lives by stalkers. Many of them limit their social life, change their place of work, and in extreme cases even go to another country to get rid of intrusive attention.
, , , , ,