妄想性障害：原因、症状、種類と治療

Delusional Disorder: Causes, Symptoms, Types & Treatment Home / Health Library / Diseases & Conditions / Delusional Disorder Advertisement Advertisement Delusional Disorder Medically Reviewed. Last updated on 05/22/2022 . Delusional disorder is a type of mental health condition in which a person can’t tell what’s real from what’s imagined. There are many types, including persecutory, jealous and grandiose types. It's treatable with psychotherapy and medication. Advertisement Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy Care at Cleveland Clinic Mental Health Care Make an Appointment Contents Arrow Down Overview Symptoms and Causes Diagnosis and Tests Management and Treatment Outlook / Prognosis Prevention Living With Overview What is delusional disorder? Delusional disorder is a type of psychotic disorder. Its main symptom is the presence of one or more delusions. Advertisement Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy A delusion is an unshakable belief in something that’s untrue. The belief isn’t a part of the person’s culture or subculture, and almost everyone else knows this belief to be false. People with delusional disorder often experience non-bizarre delusions. Non-bizarre delusions involve situations that could possibly occur in real life, such as being followed, deceived or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, these situations are either untrue or are highly exaggerated. Non-bizarre delusions are different from bizarre delusions, which include beliefs that are impossible in our reality, such as believing someone has removed an organ from your body without any physical evidence of the procedure. People with delusional disorder often continue to socialize and function well, apart from the subject of their delusion. Generally, they don’t behave in an odd or unusual manner. This is unlike people with other psychotic disorders, who might also have delusions as a symptom. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted. What are the types of delusional disorder? There are different types of delusional disorder, which are determined based on the main theme of the delusions the person experiences. The types of delusional disorder include: Advertisement Erotomanic : People with this type of delusional disorder believe that another person, often someone important or famous, is in love with them. They may attempt to contact the person of the delusion and engage in stalking behavior. Grandiose : People with this type of delusional disorder have an overinflated sense of self-worth, power, knowledge or identity. They may believe they have a great talent or have made an important discovery. Jealous : People with this type of delusional disorder believe that their spouse or sexual partner is unfaithful without any concrete evidence. Persecutory : People with this type of delusional disorder believe someone or something is mistreating, spying on or attempting to harm them (or someone close to them). People with this type of delusional disorder may make repeated complaints to legal authorities. Somatic : People with this type of delusional disorder believe that they have a physical issue or medical problem, such as a parasite or a bad odor. Mixed : People with this type of delusional disorder have two or more of the types of delusions listed above. What is the difference between delusional disorder and schizophrenia? Schizophrenia is a spectrum (or range) of conditions that involve psychotic symptoms, which include: Disorganized speech or behavior. Negative symptoms (a decrease in emotion in a person’s facial expressions and motivation). Delusional disorder is different from schizophrenia because there aren’t any other psychotic symptoms other than delusions. In addition, in contrast to schizophrenia, delusional disorder is relatively rare, and daily functioning isn’t as impaired as it is in schizophrenia. Who does delusional disorder affect? Delusional disorder most often occurs in middle to late life, with the average age of onset being 40 years. The persecutory and jealous types of delusional disorder are more common in men . The erotomanic type is more common in women. People who tend to be socially isolated are more likely to develop delusional disorder. These populations include: Immigrants who have language barriers. People who are deaf. People who are visually impaired. People over 65. How common is delusional disorder? Although delusions might be a symptom of more common disorders, such as schizophrenia, delusional disorder itself is rather rare. Approximately 0.05% to 0.1% of the adult population has delusional disorder. What is the most common type of delusional disorder? The most common type of delusional disorder is the persecutory type — when someone believes others are out to harm them despite evidence to the contrary. Advertisement Symptoms and Causes What are the signs and symptoms of delusional disorder? The presence of delusions is the most obvious sign of delusional disorder, which vary based on the type. Another characteristic of this condition is that the person often lacks self-awareness that their delusions are problematic. They’re unable to accept that their delusions are irrational or inaccurate, even if they recognize that other people would describe their delusions this way. Anger and violent behavior may be present if someone is experiencing persecutory, jealous or erotomanic delusions. People with delusional disorder may also develop anxiety and/or depression as a result of the delusions. Early symptoms of delusional disorder may include: Feelings of being exploited. Preoccupation with the loyalty or trustworthiness of friends. A tendency to read threatening meanings into benign remarks or events. Persistently holding grudges. A readiness to respond and react to perceived slights. What causes delusional disorder? As with many other psychotic disorders, researchers don’t yet know the exact cause of delusional disorder. Researchers are, however, looking at the role of various factors that may contribute to the development of the condition, including: Genetic factors : The fact that delusional disorder is more common in people who have family members with delusional disorder or schizophrenia suggests there might be a genetic factor involved. Researchers believe that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their biological children. Biological factors : Researchers are studying how abnormalities of certain areas of your brain might be involved in the development of delusional disorder. An imbalance of certain chemicals in your brain, called neurotransmitters , has been linked to the formation of delusional symptoms. Environmental and psychological factors : Evidence suggests that delusional disorder can be triggered by stress . Alcohol use disorder and substance use disorder might contribute to the condition. Hypersensitivity and ego defense mechanisms like reaction formation, projection and denial are some psychodynamic theories for the development of delusional disorder. Social isolation, envy, distrust, suspicion and low self-esteem are also some psychological factors that may lead to a person seeking an explanation for these feelings and, thus, forming a delusion as a solution. Advertisement Diagnosis and Tests How is delusional disorder diagnosed? Healthcare providers — mainly mental health professionals — diagnose delusional disorder when a person has one or more delusions for one month or more that can’t be explained by any other condition. The person must also not have the characteristic symptoms of other psychotic disorders, such as schizophrenia. If someone is experiencing signs and symptoms of delusional disorder, a healthcare provider will perform a complete medical history and physical examination. Although there aren’t any laboratory tests to diagnose delusional disorder, their healthcare provider might use various diagnostic tests — such as imaging tests, a urine drug screen and blood tests — to rule out any physical conditions, medications or substances that could be causing the symptoms. If their healthcare provider finds no physical reason for the symptoms, a consultation with a psychiatrist or psychologist will likely be made. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. They’ll ask questions about the delusions and assess the person’s mental status. The psychiatrist or psychologist may also interview family members and friends so they can provide further details about the person’s delusions and a timeline of the symptoms. Advertisement As other mental health conditions can cause delusions, mental health professionals carefully assess the person for other symptoms. Delusional disorder can be misdiagnosed as any of the following conditions: Obsessive-compulsive disorder . Schizophrenia . Delirium /major neurocognitive disorder. Bipolar disorder . Personality disorders , especially borderline personality disorder and paranoid personality disorder . Management and Treatment How is delusional disorder treated? Treatment for delusional disorder most often includes psychotherapy (talk therapy) and medication, but delusional disorder is highly resistant to treatment with medication alone. People with delusional disorder often don’t seek treatment for the condition on their own because most people with delusional disorder don’t realize their delusions are problematic or incorrect. It’s more likely