Shared Delusional Disorder
A delusional disorder shared by two or more people with close emotional links. The dominant person in this relationship has delusional disorder and convinces the nondominant person to adopt these delusional beliefs. Usually the nondominant person regains sanity once separated from the psychotic dominant person.
Predictions:
Chronic for psychotic teacher of the delusion, but short-lived for the pupil if separated from the teacher.
Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated. Unlike schizophrenia, it has; no prominent hallucinations, no disorganized speech, no grossly disorganized or catatonic behavior, no negative symptoms (i.e., diminished emotional expression or avolition), psychosocial functioning is not markedly impaired, and behavior is not obviously odd or bizarre.
Occurs where delusions are not widely accepted beliefs in the individual's culture. Delusions last longer than any associated depression or mania.
From: Treatments for delusional disorder, from Cochrane.org. Authors: Skelton M, Khokhar W, Thacker SP.
A delusional disorder shared by two or more people with close emotional links. The dominant person in this relationship has delusional disorder and convinces the nondominant person to adopt these delusional beliefs. Usually the nondominant person regains sanity once separated from the psychotic dominant person.
Predictions:
Chronic for psychotic teacher of the delusion, but short-lived for the pupil if separated from the teacher.
Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated. Unlike schizophrenia, it has; no prominent hallucinations, no disorganized speech, no grossly disorganized or catatonic behavior, no negative symptoms (i.e., diminished emotional expression or avolition), psychosocial functioning is not markedly impaired, and behavior is not obviously odd or bizarre.
Occurs where delusions are not widely accepted beliefs in the individual's culture. Delusions last longer than any associated depression or mania.
From: Treatments for delusional disorder, from Cochrane.org. Authors: Skelton M, Khokhar W, Thacker SP.
Delusional disorder is a mental illness in which long-standing delusions (strange beliefs) are the only or dominant symptom. There are several types of delusions. Some can make the person affected feel that they are being persecuted or can cause anxiety that they have an illness or disease that they do not have. People can have delusions of grandeur, so that they feel like they occupy a high position or are famous. Delusions can also involve jealousy of others or involve strange beliefs about body image, such as that they have a particular bodily defect.
Delusional disorder is considered difficult to treat. Antipsychotic drugs, antidepressants and mood-stabilising medications are frequently used to treat this mental illness and there is growing interest in psychological therapies such as psychotherapy and cognitive behavioural therapy (CBT) as a means of treatment.
This review aimed to assess the effectiveness of all current treatments for people with delusional disorder. A search for randomised controlled trials was run in 2012. Authors found 141 citations in the search but only one trial, randomising 17 people, could be included in the review. The study compared the effectiveness of CBT with supportive psychotherapy for people with delusional disorder. Participants were already taking medication and this was continued during the trial. The review was not able to include any studies or trials involving medications of any type used to treat delusional disorder.
For the study that was included, there was limited information presented that we could use. Firm conclusions were difficult to make and no evidence on improving people's behaviour and overall mental health was available. More people left the study early from the supportive psychotherapy group, but number of participants was small and the overall difference between the groups was not enough to conclude one treatment was better than the other. A positive effect for CBT was found for people's social self esteem, although again, this finding is limited by the low quantity and quality of the data and does not relate to people's social or everyday functioning.
Currently there is an overall lack of high quality evidence-based information about the treatment of delusional disorders and insufficient evidence to make recommendations for treatments of any type. Until such evidence is found, the treatment of delusional disorders will most likely include those that are considered effective for other psychotic disorders and mental health problems.Further large-scale and high quality research is needed in this area. Research could be improved by conducting trials specifically for people with delusional disorder.
Ben Gray, Senior Peer Researcher, McPin Foundation. Authors' conclusions:Despite international recognition of this disorder in psychiatric classification systems such as ICD-10 and DSM-5, there is a paucity of high quality randomised trials on delusional disorder. There is currently insufficient evidence to make evidence-based recommendations for treatments of any type for people with delusional disorder. The limited evidence that we found is not generalisable to the population of people with delusional disorder. Until further evidence is found, it seems reasonable to offer treatments which have efficacy in other psychotic disorders. Further research is needed in this area and could be enhanced in two ways: firstly, by conducting randomised trials specifically for people with delusional disorder and, secondly, by high quality reporting of results for people with delusional disorder who are often recruited into larger studies for people with a variety of psychoses
.
Background:Delusional disorder is commonly considered to be difficult to treat. Antipsychotic medications are frequently used and there is growing interest in a potential role for psychological therapies such as cognitive behavioural therapy (CBT) in the treatment of delusional disorder.