Psychiatrists view the symptoms of delusional ideas as part of the diagnostic criteria for schizophrenia, delusional or bipolar affective disorder (during the mania stages). Obsessive delusional ideas can be one of the symptoms of a paranoid personality disorder.
In the formation of a delusional idea, stages such as:
- emotional tension with mood changes, reflecting total changes in perception of the surrounding reality;
- search for new links and the meaning of non-interconnected events;
- increased feelings associated with a sense of involvement in everything that happens around;
- the formation of a new "psychological set" (retrospective falsification or delusional memory) after the final strengthening of an unshakable belief in the truth of their false notions;
- the appearance of a psychologically uncomfortable state close to the autistic, that is, there are difficulties in communication, social communication and social interaction.
Although at first people who develop delusions tend not to show noticeable violations in their daily lives, and their behavior does not provide an objective reason to consider it bizarre.
The first signs are manifested by an unreasonable change of mood. Affect is consistent with delusional content (increased anxiety, feelings of hopelessness or helplessness, suspiciousness and distrustfulness, suspiciousness or resentment). Regardless of the type of delusional ideas, there may be dysphoria - a gloomy mood and angry irritability.
Because of the characteristics of the emotional state, speech, eye contact and psychomotorics can be affected. But the memory and the level of consciousness are not violated.
Somatic type of delusional ideas can be accompanied by tactile or olfactory hallucinations; auditory or visual hallucinations are characteristic of more severe psychotic disorders, for example, schizophrenia.
In chronic alcoholism with delusions of persecution, verbal alcoholic hallucinosis is observed .
One should keep in mind the peculiarity of such violations: people who suffer from delusions show absolute certainty about their correctness and do not even perceive the obvious evidence of the opposite.
The content of delusions
Types of false conclusions in psychiatric patients are usually classified according to their subject (content). For example, the content of delusional ideas in schizotypic disorder and paranoid syndrome concerns outside control (the person is convinced that the external force controls his thoughts or actions), his own greatness or persecution.
In domestic clinical psychiatry, as well as in the diagnostic manual of the American Psychiatric Association for Mental Disorders (DSM-5), the following are the main types (types) of delusional ideas.
Delusional ideas of persecution are considered the most common. In these patients, patients are extremely suspicious and believe that someone is following them, wanting to cause harm (deceive, attack, poison, etc.). Moreover, such delusional ideas in schizophrenia lead to a reduction or complete cessation of the social functioning of the personality, and in cases of delusional disorder, delirium of persecution differs in systematization and consistency, and such people often write complaints to various instances, trying to protect themselves from "intruders".
Delusional ideas of jealousy (morbid or psychotic jealousy, delirium of jealousy ) are pursued by a spouse or sexual partner who is convinced of treason. Obsessed with delirious jealousy controls the partner in all ways and everywhere looking for "proof" of infidelity. This disorder can be diagnosed in connection with schizophrenia or bipolar disorder; it is often associated with alcoholism and sexual dysfunction; can provoke violence (including suicide and murder).
Erotic or love crazy ideas boil down to the patient's false confidence that another person, usually of a higher status, experiences a feeling of love for him. Patients can try to communicate with the object of their lust, and the denial of this feeling on his part is often misinterpreted as a confirmation of love.
Delusional ideas of greatness are expressed in the conviction that an individual possesses exceptional abilities, wealth or fame. Experts attribute this type to the symptoms of megalomania, narcissism, as well as schizophrenia or manic episodes of bipolar disorder.
Reference delusions or crazy ideas of the relationship consist in projecting personally everything that happens around a person: the patients believe that everything that happens is somehow connected with them and has a special meaning (usually negative).
This type of irrational beliefs makes a person shut up in themselves and refuse to leave the house.
Somatic delusions are associated with the concern of their body and usually consist of erroneous beliefs about physical disabilities, incurable diseases or infection by insects or parasites. Sensory experiences, for example, the sensation of parasites creeping inside, are considered as components of a systematized delusional disorder. Such patients are usually seen for the first time by dermatologists, plastic surgeons, urologists and other doctors, to whom they refer.
In addition, there are:
- Delusional ideas of harm relate to the belief in the constant theft of a person's personal belongings, money, documents, products, kitchen utensils, etc. In theft, everyone can suspect, but, first of all, relatives and neighbors.
- delusional ideas of control or influence - the belief that feelings, thoughts or actions are imposed on a person by some external force that controls them;
- delusional ideas of self-abasement - a false belief that a person does not have any abilities and is not worthy of even the most ordinary household amenities; manifested in the form of a targeted abandonment of all kinds of comfort, normal food and clothing. Characteristic combination of depression with delusions of self-deprecation;
- the delusional idea of guilt and self-flagellation makes one think that he is bad (unworthy), claiming that he has committed an unpardonable sin. It is also common in depression and can be pushed to suicide.
With a mixed type of false beliefs, the patient manifests more than one delirious idea simultaneously without an obvious dominance of any of them.