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DELUSIONAL DISORDER Delusional disorder is characterized by one or more false beliefs that persist for at least 1 month

!he false beliefs tend to be ordinary thin"s that could occur# such as bein" decei$ed by a spouse !his disorder may de$elop in people %ith a paranoid personality disorder

Doctors base the dia"nosis mainly on the person&s history after they rule out other possible causes

'eople usually remain functional and employed

A "ood doctor(patient relationship is essential to treatment

Delusional disorder usually first affects people in middle or late adult life Delusions tend to be nonbizarre and in$ol$e situations that could concei$ably occur in real life# such as bein" follo%ed# poisoned# infected# lo$ed at a distance# or decei$ed by a spouse or lo$er Se$eral subtypes of delusional disorder are reco"nized) Erotomanic: 'eople belie$e that another person is in lo$e %ith them Efforts to contact the ob*ect of the delusion throu"h telephone calls# letters# or e$en sur$eillance and stal+in" may be common ,eha$ior related to the delusion may cause conflict %ith the la% Grandiose: 'eople are con$inced that they ha$e some "reat talent or ha$e made some important disco$ery Jealous: 'eople are con$inced that a spouse or lo$er is unfaithful !his belief is based on incorrect inferences supported by dubious e$idence Under such circumstances# physical assault may be a si"nificant dan"er Persecutory: 'eople belie$e that they are bein" plotted a"ainst# spied on# mali"ned# or harassed 'eople may repeatedly attempt to obtain *ustice by appealin" to courts and other "o$ernment a"encies Rarely# $iolence may be resorted to in retaliation for ima"ined persecution Somatic: 'eople are preoccupied %ith a bodily function or attribute# such as an ima"ined physical deformity or odor !he delusion can also ta+e the form of an ima"ined "eneral medical condition# such as a parasitic infection Symptoms A delusional disorder may arise from a pree-istin" paranoid personality disorder .see 'ersonality Disorders) /luster A) Odd or Eccentric ,eha$ior0 ,e"innin" in early adulthood# people %ith a paranoid personality disorder ha$e a per$asi$e distrust and suspiciousness of others and their moti$es Early symptoms of delusional disorder may include feelin" e-ploited# bein" preoccupied %ith the loyalty or trust%orthiness of friends# readin" threatenin" meanin"s into beni"n remar+s or e$ents# bearin" "rud"es for a lon" time# and respondin" readily to percei$ed sli"hts Usually# delusional disorder does not lead to se$ere impairment 1o%e$er# people may become pro"ressi$ely in$ol$ed %ith the delusion 2ost people are able to remain employed Dia"nosis After rulin" out other specific conditions that are associated %ith delusions# a doctor bases the dia"nosis lar"ely on the person&s history !he doctor must assess the de"ree of dan"erousness# particularly the e-tent to %hich the people are %illin" to act on their delusions 'ro"nosis and !reatment

Delusional disorder does not usually cause se$ere impairment 1o%e$er# people may become pro"ressi$ely more in$ol$ed %ith their delusion 2ost people are able to remain employed A "ood doctor(patient relationship helps 1ospitalization may be needed if the doctor belie$es that people are dan"erous Antipsychotic dru"s are not "enerally used but are sometimes effecti$e in suppressin" symptoms A lon"(term treatment "oal is to shift the person&s focus a%ay from the delusion to a more constructi$e and "ratifyin" area# althou"h this "oal is fre3uently difficult to achie$e Last full re$ie%4re$ision 5une 6778 by 5uan R ,ustillo# 2D