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Mental Health and Delusional Disorder

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What Causes Delusional Disorder?

As with many other psychotic disorders, the exact cause of delusional disorder is not yet known. Researchers are, however, looking at the role of various genetic, biological, environmental or psychological factors.

  • Genetic: 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. It is believed that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their children.
  • Biological: Researchers are studying how abnormalities of certain areas of the brain might be involved in the development of delusional disorders. An imbalance of certain chemicals in the brain, called neurotransmitters, also has been linked to the formation of delusional symptoms. Neurotransmitters are substances that help nerve cells in the brain send messages to each other. An imbalance in these chemicals can interfere with the transmission of messages, leading to symptoms.
  • Environmental/psychological: Evidence suggests that delusional disorder can be triggered by stress. Alcohol and drug abuse also might contribute to the condition. People who tend to be isolated, such as immigrants or those with poor sight and hearing, appear to be more vulnerable to developing delusional disorder.

How Is Delusional Disorder Diagnosed?

If symptoms of delusional disorder are present, your doctor will perform a complete medical history and physical exam. Although there are no lab tests to specifically diagnose delusional disorder, the doctor might use various diagnostic tests, such as imaging studies or blood tests, to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. The doctor or therapist bases his or her diagnosis on the person's report of symptoms, and his or her observation of the person's attitude and behavior. The doctor or therapist then determines if the person's symptoms point to a specific disorder. A diagnosis of delusional disorder is made if a person has non-bizarre delusions for at least one month and does not have the characteristic symptoms of other psychotic disorders, such as schizophrenia.

How Is Delusional Disorder Treated?

Treatment for delusional disorder most often includes medication and psychotherapy (a type of counseling). Delusional disorder is highly resistant to treatment with medication alone.

Psychotherapy is the primary treatment for delusional disorder, including psychosocial treatment which can help with the behavioral and psychological problems associated with delusional disorder. Through therapy, patients also can learn to control their symptoms, identify early warning signs of relapse, and develop a relapse prevention plan. Psychosocial therapies include the following:

  • Individual psychotherapy: Can help the person recognize and correct the underlying thinking that has become distorted.
  • Cognitive-behavioral therapy (CBT): Can help the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings.
  • Family therapy: Can help families deal more effectively with a loved one who has delusional disorder, enabling them to contribute to a better outcome for the person.

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