Delusional disorder is one of the mental disorders, characterized by the presence of delusions, and firm beliefs in something that is not real.

What Is Delusional Disorder?

Delusional disorder, previously called paranoid disorder, is a serious mental health condition. It is characterized by the presence of delusions, and firm beliefs in something that is not real.

This is a relatively rare form of mental disorder compared to others like bipolar disorder or schizophrenia. The risk of delusional disorder in the general population is estimated to be between 0.05% and 0.1%. The disease begins between the ages of 18 and 90, the average age is about 40, and it occurs in both men and women.

Signs And Symptoms

A person with delusional disorder has had one or more non-bizarre delusional thoughts (situations that are not real but not impossible) for 1 month or more that cannot be explained by any other condition. These delusional thoughts relate to situations that can occur in real life, such as being followed by someone, being poisoned, being deceived, being planned against, or being secretly loved by someone else. However, in reality, those situations are untrue or greatly exaggerated.

It is worth noting that in people with delusional disorder, delusions have no discernible effect on their functioning and behavior. Therefore, they can continue to integrate into society and function normally, generally not behaving visibly bizarrely. This is the difference between delusional disorder and other mental disorders that also include delusions.

When you suspect you or someone else has a delusional disorder, you may notice some signs, such as:

  • Insisting on defending beliefs: Willing to argue to defend your beliefs, even if they are irrational beliefs and there is evidence (scientific and factual) that negates them. Even though the people around them say their beliefs are unreasonable, people with delusional disorders still do not accept those arguments and evidence.

  • Irritability: Feeling frustrated when others deny or do not want to hear your viewpoints and supporting beliefs.

  • Desiring government involvement: Feeling like the government is your enemy or powerful ally. People with delusional disorders may take actions like calling state agencies, visiting local authorities, organizing protests, etc.

  • Overacting: Performing outrageous acts; if there is no response, you will find reasons to convince yourself. For example, if a person has the delusion that he or she is in a relationship with a famous person, he or she may write and send hundreds of letters to that person.

  • Acting inappropriately: Acting inappropriately towards people, or conversely, receiving adverse actions from others (such as blocking, aggression, etc.). In some cases, false beliefs can lead to acts of violence or harm to the person with delusional disorder and those around them.

The severity of delusional disorder is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be evaluated for its current seriousness (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe).

WARNING: The symptoms listed are for reference only. If you suspect you have delusional disorder, see a psychologist or mental health professional to get an accurate diagnosis of your issues.

Types Of Delusional Disorder And Symptoms

Erotomanic Type

People with this disorder hold the belief that another person (usually prominent people in society such as school beauties or superiors at the company) is in love with them. These individuals are often withdrawn, dependent, and sexually inhibited, with poor levels of social and/or occupational functioning.

Grandiose Type

People with this disorder always believe that they have some great (but unrecognized) talent or insight or have made some important discoveries, despite the lack of objective evidence. Under the influence of these delusions, they will have corresponding behaviors, such as always trying to make people around them accept their "talent".

Jealous Type

People with this disorder always have suspicions that their spouse/partner is unfaithful based on trivial and unreasonable events. Their biggest concern in romantic relationships is finding evidence that the other person is unfaithful. However, they do not consider the validity of the relevant evidence. This type of delusional disorder is more common in men than women, and it can sometimes be associated with suicidal or homicidal thoughts.

Persecutory Type

This is one of the most common types of delusional disorder. The delusion involves the individual’s belief that he or she is being planned against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, irritated, or deterred in life. Therefore, they are always stressed, easily agitated, often suspicious and opposed to others.

Somatic Type

People with somatic delusional disorder always feel like there is something unusual about their body. The most common types of somatic delusions are parasitic infection, body deformities, body odor, or halitosis. People with this disorder can spend months or even years going to a doctor or specialist to look for confirmation of their actual condition.

Mixed Type

People with this disorder have two or more of the delusions listed above, but none of them predominates.

Unspecified Type

People with this disorder have dominant delusional beliefs that cannot be decided or are not described in the specific types.

WARNING: The symptoms listed are for reference only. If you suspect you have delusional disorder, see a psychologist or mental health professional to get an accurate diagnosis of your issues.

What Causes Delusional Disorder?

As with many other mental disorders, the exact cause of delusional disorder is unknown. However, many studies have shown a relationship between delusional disorder and genetic factors, biological factors, and psychological-social factors.

Genetic Factors

Delusional disorder occurs more commonly in people who have family members with delusional disorder or schizophrenia, suggesting that genetic factors may be one of the causes of this disorder. Researchers suggest that the onset of delusional disorder may be passed on from parents to their children, like other mental disorders.

Biological Factors

Abnormalities in brain regions that control perception and thinking can lead to delusional symptoms. An imbalance of neurotransmitters is also linked to delusional disorder, as it interferes with the transmission of information in the brain.

Psychological - Social Factors

Many studies show that delusional disorder can be triggered by stress. Alcohol or drug abuse can also lead to this disorder. In addition, social isolation (such as among immigrants or people with disabilities), jealousy, distrust, suspicion, and low self-esteem when developed to unacceptable levels, will lead to the formation of delusions as an explanation for one's situations and circumstances.

Treatment Of Delusional Disorder

Treating delusional disorder is not easy, partly because people with this disorder often have poor awareness and do not know they have a problem. Typically, delusional disorder is treated with medication and/or psychotherapy. For people with severe symptoms; or there is a risk of harming themselves or others, they may be hospitalized for treatment until their condition stabilizes.

The main drugs used to treat delusional disorders are called antipsychotics, which are used to regulate the amount of neurotransmitters in the brain and prevent the development of delusions. Studies show that nearly half of people with delusional disorders treated with antipsychotics show a reduction in delusions. In addition, the doctor may prescribe some sedatives or antidepressants to treat the accompanying symptoms of anxiety and depression.

WARNING: Be extremely cautious when using medication, and only use medication with the advice and prescription of a clinician.

Along with medication, psychotherapies also help individuals better manage and cope with the stress associated with delusional beliefs and their impact on their lives. Psychological therapies commonly used in the treatment of delusional disorder include:

  • Individual psychotherapy: Can help people with delusional disorders recognize and correct hidden thoughts that have become distorted.

  • Cognitive-behavioral therapy (CBT): Can help people with delusional disorders learn to recognize and change thinking and behavioral patterns that lead to negative emotions.

  • Family therapy: Can help families cope more effectively with a loved one who has a delusional disorder, thereby contributing to better results during the treatment process.

Questions and Answers About Delusional Disorder

#1: Are Delusions And Hallucinations The Same?

The answer is no. Delusion is believing something that is not true, no matter how much evidence people around you give to the contrary. For example, an individual may believe that a family member is trying to poison him or her, even though this is not true and there is no evidence at all.

Meanwhile, hallucinations involve the senses - for example, seeing, feeling, or hearing something that does not exist. Types of hallucinations are classified according to the 5 senses, including Auditory hallucinations (eg: Hearing voices or sounds that are not real); Visual hallucinations (e.g: Seeing objects that are not real or seeing real objects differently from other people); Olfactory hallucinations (eg: Smelling odors that only you can smell); Tactile hallucinations (eg: Feeling bugs crawling on the skin); Taste hallucinations (eg: Feeling of a strange taste in the mouth).

#2: How To Know If Someone You Know Is Suffering From Delusional Disorder?

It is difficult to know whether a person has a delusional disorder or not because delusions do not have a clear effect on their functioning and behavior. However, in some cases, people with delusional disorders can become so obsessed with their delusions that they disrupt their lives. If you observe that someone you know has symptoms of delusional disorder (mentioned above), go to a medical facility for timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. The earlier intervention is made, the less the delusional disorder will affect their lives.

#3: How Can I Help Someone I Know With Delusional Disorder?

Some tips for caring for people with delusional disorder: 

  • Avoid criticism. Judgment can make people with delusional disorder feel anxious, lonely, or depressed. When speaking with them, be conscious of tone and word choice. Attempt to be non-confrontational and calm, expressing concern as a form of opinion, instead of judgment. It is best to talk to your loved ones when they are not in delusion.

  • Stay neuter. Do not try to convince your loved one that their delusions are not real. This can lead to arguments, explosive behavior, and constant conflict, which will further isolate them.

  • Help and support. You can go with your loved one to doctor's appointments, help them keep up with their medication schedule, help with housework and errands, go for a walk or exercise with them, or visit if they're feeling depressed.

  • Be prepared. Make a contingency plan in case your loved one is at risk of hurting themselves or others. If your loved one is in crisis, try to get them to the hospital so they do not hurt themselves or others.

  • If you are a direct caregiver for someone with a delusional disorder, it is important to look after your own physical and mental health as well.

If you feel you are having symptoms of delusional disorder, go to a medical facility for a timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.


[1] Delusional Disorder.

[2] Diagnostic and statistical manual of mental disorders _ DSM-5.

[3] Delusional Disorder: Types, Symptoms, and Treatment.

[4] Caring for Someone With Delusional Disorder.

[5] Symptoms of Delusional Disorder.



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