What is Delusional disorder? How Is It Different From Schizophrenia?

Delusional disorder is very different from schizophrenia. The only thing they have in common is the presence of delusions. Schizophrenia is delusions, plus hallucinations, disorganized thoughts and behavior and other cognitive or thinking problems.

A delusion is a fixed false belief. Despite evidence that goes against what you believe, you still believe it. Delusions can be a part of other psychotic experiences like mania, depression and substance intoxication or withdrawal.

The delusions you see in schizophrenia tend to be bizarre in nature whereas the delusions you get with delusional disorder are non-bizarre and possible. An example of a bizarre delusion is believing that our insides are being replace while we sleep. A non-bizarre delusion is believing that a famous person is in love with you. It’s probably really unlikely, but it’s possible.

The main criteria for delusional disorder is that you have a delusion that lasts at least one month. There are certain personality disorders where people can experience very short-term psychotic experiences that last minutes to hours. You can see this with paranoid personality disorder and borderline personality disorder
But those very short, transient psychotic experiences would not be considered a delusional disorder.

There are 6 types of delusions in delusional disorder.
1. Erotomanic type. This is when you believe that someone is in love with you.
2. Grandiose type. With this delusion, you believe that you have a great talent or insight that people just haven’t discovered yet or you’re on the verge of a big discovery.
3. Somatic. It involves delusional beliefs about body functions or sensations.
Common somatic beliefs are: you emit a foul odor, you’re infested by insects in your skin, you have a parasite in your body, or parts of the body are not functioning.
4. Jealous type. With this, the person believes their partner is unfaithful. They may see minor things like you have disheveled clothing as evidence of the infidelity.

5. Persecutory. With this type the person feels they are being conspired against, spied on or poisoned. The person may also feel like someone or some entity is holding them back from achieving a certain goal.

6. Mixed type. This is where no one specific theme predominates. You may have features of a few of the types.

These delusional themes can be present in illnesses that have delusions. For example mania can have grandiose delusions. With psychotic depression, people can have persecutory delusions.

Delusional disorder may not be obvious to other people. Because the delusions can be compartmentalized in a way that you can have normal functioning in every other aspect of your life that doesn’t involve the delusion.

Delusional disorder tends to remain stable over time, meaning it can intensify and cause problems or run quietly in the background of your mind. But, a small portion of people can go on to develop schizophrenia – not because it causes schizophrenia, but it may be more of what we call a prodrome to schizophrenia. A prodrome is an early stage of an illness where you can have some symptoms of a larger illness but not all of them. So in some people, delusional disorder can lead up to schizophrenia, but that’s not the usual.

If the disorder doesn’t cause a lot of dysfunction, you may not seek professional help for your beliefs. Since it doesn’t make you globally psychotic and out of touch, many people will just keep to themselves about their beliefs to reduce conflict.

Therefore, delusional disorder is something people can live with without seeking help. Sometimes the intensity of the belief can come and go such that you get less focused on it. Then under stress, the thoughts can ramp up again.

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Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[Adrian_Estando]

When I was a child (in the 70s) I used to fantasize that in the distant future information like this would be readily available to me in an instant whenever and wherever I wanted. I didn’t know how. I had science books but never enough or access to enough books. I’m glad I lived long enough to experience the net and great channels on YT like this one. Thank you, Dr. Marks.

[latonyagarner]

I think I suffer from persecutory delusions. I think people are constantly watching me, but not necessarily trying to harm me.

[shiningdalek]

I had delusional disorder for around 7-8 years, and I'm happy to see someone talking about it, especially as well as you do. You explain everything important in a very clear way. Thank you.

[KeiranCounsellKC]

I went through psychosis and it was horrible. People always say about thoughts and voices and visual hallucinations, nobody ever tells you they add up and up and everything can add to it, then people dont realise that your thoughts could tell you little bombs are being implanted in your body by things out of sight but your body and brain can generate the actual feeling of needles going into the skin and little bombs going off or nerves and muscles being pinched and the sounds too, it hurt, nobody told me it could be that bad ever

[notpub]

I had a friend in high school who seemed "normal" in every way but one: She was convinced that David Bowie (the musician/actor RIP) was in love with her. Given the chance, she would tell anyone and everyone this. She also had a collection of ongoing lies around this theme; for example, she missed school because David had asked her to join him in England and help him out of a song writing rut; or she couldn't go out because David was going to call and she had some suggestions on a specific "top secret" release that was about to drop. If someone innocently said something like, "Oh yeah, I just love David Bowie!" She would say something like, "Really? Would you like to meet him? I can arrange that you know." Sometimes when she'd pull out an album of his to play, she'd hand the inner sleeve around and gush about "how exciting" that it was that David had "finally" recognized her in the thank yous or writing credits. When someone would point out that her name was not there, she'd respond with surprise, examine it closely, and say something like, "Oh yeah, you're right....this is the American release. They wouldn't let him put it on there for copyright reasons. But he still managed to get it on the UK release, which is all that really matters. Sweet, sweet David, always thinking of me." Everyone in her family knew she had this delusion but they thought it was funny and that she was just kidding around or "pretending." I don't think she ever got treatment for it.

[trixiebaldwin]

I had a somatic delusion while I was pregnant with my first son. I was convinced I had a parasite growing inside of me. I only told my husband and a good friend about it. She even joked after I gave birth that he wasn't a parasite after all but a perfectly healthy baby boy. I can laugh about it now, but at the time I had so much anxiety over it. It kind of makes more sense, now, because that's when all of my mental health issues began. About 6 months after he was born, I developed severe anxiety and depression, bad enough to be diagnosed with post-partum depression.

[jl]

Remember teach children to always treat other children with kindness

[Taylor.h]

You are literally better than my own psychology professor. Bless this channel

[Leo-jwex]

Dr.Marks is such a blessing...So good at discussing complex mental health issues in a very easily understood teaching video.

[TracvM]

I’m so appreciative of your information!!! Thank you so much

[trekpac]

Your video was most helpful, Dr. Marks, in clarifying points about delusional disorder.
We have found that many psychiatrists do not have good training in identifying and treating DD, especially those who did their training over 20 years ago. But it is so important to read a lot on it and help get the diagnosis right.

[grubbymanz]

a good subject for a video would be determining OCD from delusional disorder, contamination vs infestation etc. I see many patients with either psychosis or severe OCD that ride the line between obsession/delusion.

[jeffvarley]

Dr. Marks. Thankyou once again for generously, selflessly bringing this video to us. I want you to know that I appreciate your posts and I look forward to seeing the new ones. Have a great day.

[MooWithMetubes]

I can relate to the somatic delusions. I started having heart palpitations when I was 19 and since then I cant focus on anything other than that. I'm just waiting to drop dead. I'm 35 now, and that alone has completely eexhausted me.

[walterkropff]

Dr. can you talk about substance induced symptoms, like cannabis and methylphenidate induced mania or meth induced psychosis. I love your videos, thank you for sharing your knowledge! It's really entertaining to watch

[celinenoort]

What a great explanation of paranoid delusion. That’s exactly how my mum is. Doctors and others initially thought it was early onset dementia but I put two and two together and realised she was always paranoid, but covid iso precipitated her symptoms and magnified them m’as she didn’t life to forget the issues into. She is now wrapped in her stories… very sad to witness. At least understanding is very useful for children and supporting family members.

[AyaMohamed-ijhu]

Hello Dr tracey,
Can you talk about maladaptive daydreaming? Because it is highly misunderstood and not talked about enough

[anders]

Thank you Dr. Tracey. I personaly have paranoid schizophrenia, and have often wondered why sincere religious views were not clasified as such. I think i got a better understanding of it from your video, so thank you.

[maisieburns]

I’m glad you explain clearly in these videos. Everybody has intrusive thoughts..mood swings..sometimes miss hears a voice thinking it was a ‘ghost’..feeling family are against you.. I guess eveyone would want at least 1 celeb they fancy to like them back of course 🤣😳it’s nothing to worry about it’s all normal but people like myself with anxiey can sometimes over think maybe this is me and when watching these videos (I’ve binge a lot of your videos for education) you can see that your not going insane, crazy or ‘not normal’ and anybody who has these symptoms can feel safe in your videos and seek help.
I can’t imagine what it feels like to have BPD, Psychosis, ect I hope eveyone who watches these videos seeks help if you need to and always remember you’re human who is still worthy of love !
Amazing content Dr!

[diannmurphy]

I'm so glad you shared this video with us. I've been having some trouble in this department, so I'll see a dermatologist this morning and, if my tests come back clear, I will be in immediate contact with my psych doc.