297.1 Delusional disorder
Erotomanic (delusions that another person of higher status is in love with the individual)
Grandiose (delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or
Jealous (delusions that one’s sexual partner is unfaithful)
Persecutory (delusions that one, or someone to whom one is close, is being malevolently treated in some
Somatic (delusions that one has some physical defect or general medical condition)
Mixed (delusions characteristic of more than one of the above types, but no one theme predominates)
Emotional development is delayed because of a lack of maternal stimulation
attention. The infant is
deprived of a sense of security and fails to establish basic trust. A fragile ego results in severely impaired
self-esteem, a sense of loss of control, fear, and severe anxiety. A suspicious attitude toward others is
manifested and may continue throughout life. Projection is the most common mechanism used as a defense
A relatively strong familial pattern of involvement appears to be associated with these disorders.
Individuals whose family members manifest symptoms of these disorders are at greater risk for
development than the general population. Twin studies have also suggested genetic involvement.
Some theorists believe that paranoid persons had parents who were distant, rigid, demanding, and
perfectionistic, engendering rage, a sense of exaggerated self-importance, and mistrust in the individual.
The clients become vulnerable as adults because of this early experience.
CLIENT ASSESSMENT DATA BASE
Refer to CP: Schizophrenia for physical symptoms.
May present with severe anxiety; inability to relax, exaggeration of difficulties, being easily agitated
Expresses feelings of inadequacy, worthlessness, lack of acceptance, and trust of others
Demonstrates difficulty in coping with stress, uses maladjusted coping mechanisms (e.g., excessive use of
projection and aggressive behavior, takes unnecessary precautions, avoids accepting blame)
Nonbizarre delusional system of at least 1 month’s duration
Experiencing emotions and behavior congruent with the content of belief system
fears that either self or
significant others are in danger, are being followed
conspired against, poisoned, infected; have a
disease; are being deceived by one’s spouse, cheated by others; are loving
being loved from a