30/08/2025
๐ง Delusional Disorder ๐ง
Delusional Disorder is a recognised mental health condition classified in both the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision) and the ICD-11 (International Classification of Diseases, 11th Revision).
DSM-5-TR: A psychiatric condition characterized by the presence of one or more delusions lasting at least one month. These delusions are fixed beliefs that are not in line with reality, but unlike schizophrenia, the personโs functioning is not markedly impaired outside of the delusional topic, and behavior is not bizarre or odd. (APA, 2022)
ICD-11 definition: Persistent delusional disorder involves the presence of one or more delusions lasting at least 3 months. Other psychotic symptoms (e.g., hallucinations) are either absent or not prominent. Functioning may be affected, but often only in areas related to the delusion. (WHO, 2019)
๐ How Difficult It Can Be for the Person
People with delusional disorder often donโt recognize their beliefs as delusional (low insight). This can cause significant distress, especially in relationships, work, and daily functioning.
๐ For example:
- A person with persecutory delusions may constantly feel unsafe and suspicious.
- Someone with jealous delusions may accuse a partner of infidelity without evidence, straining relationships.
Because their thinking outside the delusion can appear โnormal,โ family and friends may struggle to understand why the person canโt just โlet goโ of the belief. Many individuals feel isolated, misunderstood, and defensive when others challenge their reality.
๐ How to Help Someone with Delusional Disorder
1. Build trust and safety: Avoid directly confronting or arguing about the delusion, as this may increase defensiveness. Show empathy for the personโs feelings, even if you donโt agree with the belief.
2. Encourage professional support: Treatment may include antipsychotic medication and psychotherapy (such as Cognitive Behavioral Therapy for psychosis). Gentle encouragement to seek care is often more effective than confrontation.
3. Promote stability: Encourage regular routines, stress management, and healthy lifestyle habits (sleep, exercise, nutrition).
4. Support without reinforcing the delusion: Validate emotions (โI see this is frightening for youโ) rather than the false belief itself.
5. Family education and therapy: Families benefit from learning how to support without enabling delusional thinking.
๐ References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.)
Illustration credit: MindJournal
Information credit: Mubarak Mansoor Ali