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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. Abnormalities in the functioning of brain regions that control perception and thinking may be linked to the formation of delusional 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 likely 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 can be very difficult to treat in part because its sufferers often have poor insight and do not recognize that a psychiatric problem exists.  Studies show that close to half of patients treated with antipsychotic medications show at least partial improvement.

Antipsychotic medicines are the primary treatment for delusional disorder.  Sometimes, psychotherapy can also be a helpful adjunct to medications as a way to help patients better manage and cope with the stresses related to their delusional beliefs and its impact on their lives. Psychotherapies that may be helpful in delsional disorder 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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