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Delusional Disorder (Paranoia) pp. 496-501

Delusional disorder is more commonly recognized by its name of long time use, paranoia.
The definition used in the book for this disorder is impaired contact with reality but
without the bizarreness, fragmentation, and severe personality disorganization
characteristic of schizophrenia. We look at the two different categories related to
paranoia, delusional disorder, and shared psychotic disorder. As stated above, delusional
disorder is defined as paranoia, and shared psychotic disorder is when two or more people
usually of the same family develop persistent, interlocking delusional ideas.

Delusional disorder is difficult for clinicians to diagnose because of term is not exact
in it’s meaning and leaves a lot of room for interpretation. The term paranoia is
felt to be too readily used in cases where it is simply a disagreement on an issue, not a
delusional thought or perception. The book uses the example of Hitler and the Nazi
movement against Jews, a lot of people do not believe that it ever happened, but facts
show otherwise and the thought is held sincerely by many people, regardless of the
evidence. In everyday thought, people may experience paranoia, but to be psychotic and
diagnosed as such, it must specified in categories meriting the term
“delusional”. These categories are as follows: Persecutory type, Jealous type,
Erotomanic type, Somatic type, Grandiose type, and Mixed. The person falling into the
category labeled persecutory have delusions that they themselves or someone they are close
to is being stalked, being spied on, or the subject of false rumors regarding immoral
behavior or illegal action. The jealous type is pretty self explanatory, one believes that
their significant other is unfaithful. Those with the type erotomanic feel that someone of
higher social status, such as a movie star, loves them and wants a sexual relationship
with them. Somatic type includes people that believe they are plagued with a disease that
is absurd or unreal. Grandiose type patients have the delusion that they have more power,
talent and ability than is actually true, or they have a relationship with someone who
does, such as a political leader or movie star. The last of these types is the mixed type,
a mixture of the above types or the absence of a predominant type. The diagnosis of
delusional disorder is considered rare among clinical institutions and hospitals, but is
not an accurate example of how often it actually occurs. Many people with delusional
disorder can function normally in society and carry on with their lives unless they become
seriously inflicted with delusional behavior. The decision that someone may be in need of
psychological treatment for this disorder is a difficult one to decide because of the gray
area separating those that have a few thoughts along the delusional line and those that
have a serious problem with it.
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