Delusional disorders are confusing for those afflicted and for their loved ones. If you or someone you care about seems to be suffering from a delusional disorder, learn the differences between similar illnesses and how common delusional disorders are for people over the age of 65.
What Is a Delusional Disorder?
A delusional disorder occurs when a person experiences delusions for at least one month without any other psychotic symptoms. Delusions are false beliefs about oneself or the world that persist even when the individual is told the truth. For example, an individual with grandiose delusions may believe that she is famous and that there are secret cameras hidden around the world capturing her every move to be broadcast on television. Even when she is told that she is not famous or is shown proof (like not finding her on television), she continues to believe the delusion. There are different types of delusions, or delusional disorders, including:
- Erotomania: Believing that another individual is in a relationship or in love with the person
- Grandiose: Believing that one is wealthy, famous or has extraordinary abilities
- Nihilistic: Believing that a major disaster is going to happen
- Persecutory: Believing that one is going to be harmed in some way by another person or group
- Referential: Believing environmental cues or others’ comments or gestures are directed at the person
- Somatic: Believing that some perceived bodily sensation or function has a special or sinister meaning
Delusions are different from psychosis, but can be a symptom of psychosis. Psychosis involves hallucinations (seeing, feeling or hearing things that are not there), inappropriate emotions or a lack of emotion, trouble thinking clearly or concentrating, and possibly, delusions as well. When a person has a delusional disorder, he or she does not have any of the other symptoms of psychosis.
How Common Are Delusional Disorders?
As of 2013, approximately 0.02% of the United States population suffered from a delusional disorder. However, mental health professionals believe this figure may not be accurate because many people do not report their delusional beliefs to professionals, or their family members do not report them. Due to the risk of cognitive decline in late age, the elderly are at increased risk of delusional disorders. Delusional disorders can affect elderly individuals with or without cognitive impairment. About 5.5% of individuals over the age of 85 have a delusional disorder. Also, research has shown that approximately 7% of elderly individuals with paranoid ideology have a delusional disorder. It is also possible that a delusional disorder may develop in the presence of other conditions common to the elderly population, such as Alzheimer’s disease, dementia, or stroke. However, diagnostic criteria for co-occurring disorders often overlap. As a result, the prevalence of delusional disorder in patients with Alzheimer’s disease ranges anywhere from 10% to 73%, but most researchers believe the prevalence I s at about 30%. Many people with delusional disorders are able to function well under treatment with antipsychotic medications. If you or someone you love may be suffering from a delusional disorder, seek help from a trained mental health professional. Sources American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association. Bourgeois, J. A., Khan, R. A., Hilty, D. M., Talavera, F. (Ed.), & Bienenfeld, D. (Ed.). (2015). Delusional Disorder. https://emedicine.medscape.com/article/292991-overview Holt, A. E. M. & Albert, M. L. (2006). Cognitive neuroscience of delusions in aging. Neuropsychology Disorders and Treatment, 2(2), 181-189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671775/ National Alliance on Mental Illness. (n.d.). Early Psychosis And Psychosis. https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Psychosis