Delusions

1. Delusions –
Psychiatry
K. Kavindya M. Fernando
JMJ 1

2. Delusions
• Is a belief that is held firmly
• but on inadequate grounds,
• is not affected by rational argument or
evidence to the country.
• And it is not conventional belief that the
person might be expected to hold given
• his cultural background and level of
education
JMJ 2

3. Delusions
Primary
• One that occurs
suddenly without any
other abnormal
mental even leading to
it.
• Rare
• When occur- strongly
suggest schizophrenia
Secondary
• Arise from previous
abnormal idea or
experience
• Hallucinations
• Mood
• Another delusion
JMJ 3

4. Other mental phenomena
related to delusions
• Delusional mood
• In explicable feeling of apprehension that is
followed before long by a delusion that explains
it.
• Delusional Perception
• Misinterpretation of the significance of
something perceived normally
• Delusional memory
• Retrospective delusional misinterpretation of
memories of actual events
JMJ 4

5. JMJ 5

6. Shared delusions / folie à
deux
JMJ 6

7. Delusional themes
JMJ 7
Persecutory (Paranoid) Schizophrenia , organic diorders, depression
Delusions of reference Schizophrenia
Grandiose and expansive delusions Mania, Schizophrenia
Delusions of guilt & worthlessness Severe Depressive disorders
Nihilistic delusions Severe Depressive diorders
Hypochondriacal delusions
Delusions of jealousy
Sexual or amorous delusions
Religious delusions
Delusion of control Schizophrenia
Delusions concerning the possession
of thoughts
• Delusion of thought insertion
• Delusion of thought withdrawal
• Delusion of thought broadcasting

8. Persecutory delusions
• Ideas that people or organizations are trying to
inflict harm on the patient,
• damage his reputation,
• or make him insane.
• Sometimes normal in some people
• Common in schizophrenia
• Occur in organic states and severe depressive
disorders
JMJ 8

9. Delusions of Reference
• Concerned with the idea that objects,
events or the actions of other people have a
special significance for the patient.
• Ex:
• A remark heard on television is believed to be
directed specifically to the patient, or a gesture
by a stranger is believed to convey something
about the patient
• Associate with schizophrenia
JMJ 9

10. Grandiose & Expansive
delusions
• Beliefs of exaggerated self-importance
• Occur in mania & sometimes in schizophrenia
JMJ 10

11. Delusions of guilt and
worthlessness
• Beliefs that the person has done something
shameful or sinful.
• Usually concerns innocent errors
• Most often in severe depressive disorders
JMJ 11

12. Nihilistic Delusions
• Beliefs that the patient’s career is finished,
• that he is about to die or
• has no money, or
• that the world is doomed
• Common in severe
depressive disorders
JMJ 12

13. Hypochondriacal Delusions
• False beliefs about the presence of disease.
• Common among elderly
• Related dysmorphophobic delusions –
concerned with the appearance of parts of
the body
• Severe depressive &
schizophrenia
JMJ 13

14. Delusions of jealousy
• Common among men
• ‘Morbid (pathological) jealousy’
• May lead to dangerously aggressive behavior
towards the person who is believed to be
unfaithful
JMJ 14

15. Sexual or amorous delusions
• Common among women
• They believe that she is loved by a man who
has never spoken to her & who is
inaccessible
JMJ 15

16. Religious Delusions
• May be concerned with guilt or with special
powers.
JMJ 16

17. Delusions of Control
• Beliefs that personal actions, impulses or
thoughts are controlled by an outside
agency.
• This has to be distinguished
JMJ 17

18. Delusions concerning the
possession of thoughts
• Delusions of thought insertion
• Some of the person’s thoughts have been
implanted by an outside agency
• Delusion of thought withdrawal
• Some of their thoughts have been taken away
• Delusions of thought broadcasting
• Some of their thoughts are known to other
people through telepathy, radio, or some other
unusual way
JMJ 18

19. JMJ 19