Delusional Disorder: Types, Causes, and Management

5 December 2013
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5 December 2013, Comments: 0

Delusional disorder is a type of psychosis, in

which a person cannot differentiate what is real from what is illusory. It is mainly characterized by the presence of delusions, an unshakeable belief in something that is fallacious, usually shared with no one.Delusional people believe with total conviction that what they believe is true and no amount of logic, reason or facts can alter this belief.  These delusions usually occur as a result of misinterpreted perceptions or experiences. In reality, these circumstances are either highly exaggerated or completely untrue.  Some common examples include being stalked, conspired against or loved from a distance.

Types of Delusional Disorders

There are several different types of delusional disorder. Some of the types of delusional disorders include:

  • Grandiose: characterized by belief of over-inflated sense of worth, identity, power or knowledge; may also believe he/ she is of great talent or has made an important discovery
  • Erotomanic: characterized by belief that another person, frequently someone famous or important, is in love with him/ her
  • Jealous: characterized by belief that partner is disloyal
  • Reference: characterized by beliefs that other people’s thoughts and behaviours are directed towards oneself
  • Persecutory: characterized by a belief that someone they know is being mistreated or that someone is spying them with or without plans to harm them
  • Somatic: characterized by a belief that he/ she has a medical or physical condition
  • Mixed: a person has two or more types of delusional disorders

Causes of Delusional Disorders

Although the exact cause of delusional disorder is still yet to be determined, the following may cause false fixed beliefs that are out of touch with reality:

  • Delirium (brain chemistry imbalance)
  • Mood disorders, such as bipolar disorders, major depressive disorder, etc.
  • Psychotic disorders, such as substance-induced psychosis
  • Organic disorders, such as dementia, etc.
  • Perception problems

Management for Delusional Disorders

Treatment will be tailored according to the underlying cause. Treatment most often includes medications and psychotherapy. First aid should be given to delusional patients to avoid any harmful or destructive behaviour. The following steps are generally recommended:

  • Assess the situation. Ask the patient about the delusions. One may try asking:
    • Who is trying to hurt you? Could you think why? How might this happen?
  • If any part of the delusion was real, validate it, such as:
    • Yes, the visitor was here a while ago but I did not hear him talking about you.
  • Avoid agreeing to the patient’s wrong thinking. Do not deny the person’s experience but show respect and give your own understanding or impression of the situation. Listen quietly. Recognise the feelings that can be aroused by the delusions. Respond to the underlying feelings instead of the content of the delusion.  Try saying:
    • It must feel frightening that to think that there is a conspiracy against you.
  • Do not debate the delusion to avoid risks of including you in the delusion. Do not take the patient’s delusions personally even if they are focused on you or someone close to you.
Delusional Disorder

Delusional Disorder

Disclaimer: This article does not provide medical advice or treatment. The information given should not be used for self-diagnosis of possible conditions. Seek medical attention when necessary. Understanding symptoms that are commonly present in medical situations may help when taking first aid training. To learn more about to how to manage mental symptoms, such as delusions, enrol in First Aid Courses with workplace approved Training.


Delusions. (ND). Queensland Mind Essentials. Retrieved October 3, 2013, from

Mental Health and Delusional Disorder. (ND). WebMD. Retrieved October 3, 2013, from

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