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Encyclopedia > Delusion
Delusion
Classification & external resources
ICD-10 F22
ICD-9 297

A delusion is commonly defined as a fixed false belief and is used in everyday language to describe a belief that is either false, fanciful or derived from deception. In psychiatry, the definition is necessarily more precise and implies that the belief is pathological (the result of an illness or illness process). As a pathology it is distinct from a belief based on false or incomplete information or certain effects of perception which would more properly be termed an aperception or illusion. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... False is the antonym of the adjective true. ... This article needs additional references or sources for verification. ... This article or section includes a list of works cited but its sources remain unclear because it lacks in-text citations. ... Psychiatry is a branch of medicine dealing with the prevention, assessment, diagnosis, treatment, and rehabilitation of the mind and mental illness. ... Psychopathology is a term which refers to either the study of mental illness or mental distress, or the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment. ... This article needs more context around or a better explanation of technical details to make it more accessible to general readers and technical readers outside the specialty, without removing technical details. ... In psychology and the cognitive sciences, perception is the process of acquiring, interpreting, selecting, and organizing sensory information. ... An illusion is a distortion of a sensory perception, revealing how the brain normally organizes and interprets sensory stimulation. ...


Delusions typically occur in the context of neurological or mental illness, although they are not tied to any particular disease and have been found to occur in the context of many pathological states (both physical and mental). However, they are of particular diagnostic importance in psychotic disorders and particularly in schizophrenia. A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...

Contents

Psychiatric definition

Although non-specific concepts of madness have been around for several thousand years, the psychiatrist and philosopher Karl Jaspers was the first to define the three main criteria for a belief to be considered delusional in his book General Psychopathology. These criteria are: This article or section does not cite its references or sources. ...

  • certainty (held with absolute conviction))
  • incorrigibility (not changeable by compelling counterargument or proof to the contrary)
  • impossibility or falsity of content (implausible, bizarre or patently untrue)

These criteria still live on in modern psychiatric diagnosis. In the most recent Diagnostic and Statistical Manual of Mental Disorders, a delusion is defined as: The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ...

A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith).

For other uses, see Culture (disambiguation). ... Faith has two general implications which can be implied either exclusively or mutually; To Trust: Believing a certain variable will act a specific way despite the potential influence of known or unknown change. ...

Diagnostic issues

The modern definition and Jaspers' original criteria have been criticised, as counter-examples can be shown for every defining feature.


Studies on psychiatric patients have shown that delusions can be seen to vary in intensity and conviction over time which suggests that certainty and incorrigibility are not necessary components of a delusional belief.[1]


Delusions do not necessarily have to be false or 'incorrect inferences about external reality'.[2] Some religious or spiritual beliefs (such as 'I believe in the existence of God') by their nature may not be falsifiable, and hence cannot be described as false or incorrect, no matter whether the person holding these beliefs was diagnosed as delusional or not. [3] This article discusses the term God in the context of monotheism and henotheism. ...


In other situations the delusion may turn out to be true belief.[4] For example, delusional jealousy, where a person believes that their partner is being unfaithful (and may even follow them into the bathroom believing them to be seeing their lover even during the briefest of partings) may result in the faithful partner being driven to infidelity by the constant and unreasonable strain put on them by their delusional spouse. In this case the delusion does not cease to be a delusion because the content later turns out to be true. Delusional jealousy or Othello syndrome is a psychiatric disorder in which a person holds a delusional belief that their spouse or sexual partner is being unfaithful. ...


In other cases, the delusion may be assumed to be false by a doctor or psychiatrist assessing the belief, because it seems to be unlikely, bizarre or held with excessive conviction. Psychiatrists rarely have the time or resources to check the validity of a person’s claims leading to some true beliefs to be erroneously classified as delusional.[5] This is known as the Martha Mitchell effect, after the wife of the attorney general who alleged that illegal activity was taking place in the White House. At the time her claims were thought to be signs of mental illness, and only after the Watergate scandal broke was she proved right (and hence sane). Look up assumption in Wiktionary, the free dictionary. ... The Martha Mitchell effect is the process by which a psychiatrist, psychologist, or other mental health clinician mistakes his or her patients belief in real events for delusion and diagnoses accordingly. ... Seal of the United States Department of Justice The United States Attorney General is the head of the United States Department of Justice (see 28 U.S.C. Â§ 503) concerned with legal affairs and is the chief law enforcement officer of the United States government. ... For other uses, see White House (disambiguation). ... The Watergate scandal was a 1972 break-in at the Democratic National Committee headquarters at a Watergate Office Building in Washington, D.C. by members of Richard Nixons administration and the resulting cover-up which led to the resignation of the President. ...


Similar factors have led to criticisms of Jaspers' definition of true delusions as being ultimately 'un-understandable'. Critics (such as R. D. Laing) have argued that this leads to the diagnosis of delusions being based on the subjective understanding of a particular psychiatrist, who may not have access to all the information which might make a belief otherwise interpretable. R.D.Laing; photo credit Robert E. Haraldsen Ronald David Laing (October 7, 1927–August 23, 1989), was a Scottish psychiatrist who wrote extensively on mental illness and particularly the experience of psychosis. ... This article is in need of attention. ...


Another difficulty with the diagnosis of delusions is that almost all of these features can be found in "normal" beliefs. Many religious beliefs hold exactly the same features, yet are not universally considered delusional. Similarly, Thomas Kuhn argued in The Structure of Scientific Revolutions that scientists can hold strong beliefs in scientific theories despite considerable apparent discrepancies with experimental evidence.[6] Cover of a biography of Thomas Kuhn. ... To meet Wikipedias quality standards, this article or section may require cleanup. ...


These factors have led the psychiatrist Anthony David to note that "there is no acceptable (rather than accepted) definition of a delusion".[7] In practice psychiatrists tend to diagnose a belief as delusional if it is either patently bizarre, causing significant distress, or excessively pre-occupies the patient, especially if the person is subsequently unswayed in belief by counter-evidence or reasonable arguments. Anthony David is Professor of Cognitive neuropsychiatry at the Institute of Psychiatry, part of Kings College London. ...


Indicators of a delusion

(Munro, 1999)

  1. The patient expresses an idea or belief with unusual persistence or force.
  2. That idea appears to exert an undue influence on his or her life, and the way of life is often altered to an inexplicable extent.
  3. Despite his profound conviction, there is often a quality of secretiveness or suspicion when the patient is questioned about it.
  4. The individual tends to be humorless and oversensitive, especially about the belief.
  5. There is a quality of centrality: no mater how unlikely it is that these strange things are happening to him, the patient accepts them relatively unquestioningly.
  6. An attempt to contradict the belief is likely to arouse an inappropriately strong emotional reaction, often with irritability and hostility.
  7. The belief is, at the least, unlikely.
  8. The patient is emotionally overinvested in the idea and it overwhelms other elements of his psyche (psychology).
  9. The delusion, if acted out, often leads to behaviors which are abnormal and/or out of character, although perhaps understandable in the light of the delusional beliefs.
  10. Individuals who know the patient will observe that his belief and behavior are uncharacteristic and alien.

The neutrality of this article is disputed. ...

See also

The Capgras delusion (or Capgrass syndrome) is a rare disorder in which a person holds a delusional belief that an acquaintance, usually a spouse or other close family member, has been replaced by an identical looking impostor. ... Clinical lycanthropy is a psychiatric syndrome that involves a delusional belief that the affected person is, or has, transformed into an animal. ... The Cotard delusion or Cotards syndrome is a rare neuropsychiatric disorder in which a person holds a delusional belief that he or she is dead, does not exist, is putrefying or has lost his/her blood or internal organs. ... Delusional disorder is a psychiatric diagnosis denoting a psychotic mental illness that involves holding one or more non-bizarre delusions in the absence of any other significant psychopathology (signs or symptoms of mental illness). ... Delusional jealousy or Othello syndrome is a psychiatric disorder in which a person holds a delusional belief that their spouse or sexual partner is being unfaithful. ... Delusional misidentification syndrome is an umbrella term for a group of delusional disorders that occur in the context of mental or neurological illness. ... Delusional parasitosis is a form of psychosis in which sufferers hold a delusional belief they are infested with parasites [1]. Delusional parasitosis is also referred to as Ekboms Syndrome, named after a Swedish neurologist, Karl Axel Ekbom,[2] who published seminal accounts of the disease in 1937 and 1938. ... Erotomania is a rare disorder in which a person holds a delusional belief that another person, usually of a higher social status, is in love with them. ... Folie à deux (literally, a madness shared by two) is a rare psychiatric syndrome in which a symptom of psychosis (particularly a paranoid or delusional belief) is transmitted from one individual to another. ... The Fregoli delusion or Fregoli syndrome is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes their appearance or is in disguise. ... Look up megalomania in Wiktionary, the free dictionary. ... An illusion is a distortion of a sensory perception, revealing how the brain normally organizes and interprets sensory stimulation. ... This article or section does not cite its references or sources. ... The Jerusalem syndrome is the name given to a group of mental phenomena involving the presence of either religiously themed obsessive ideas, delusions or other psychosis-like experiences, that are triggered by, or lead to, a visit to the city of Jerusalem. ... R.D.Laing; photo credit Robert E. Haraldsen Ronald David Laing (October 7, 1927–August 23, 1989), was a Scottish psychiatrist who wrote extensively on mental illness and particularly the experience of psychosis. ... Reduplicative paramnesia is the delusional belief that a place or location has been duplicated, existing in two or more places simultaneously, or that it has been relocated to another site. ... The Martha Mitchell effect is the process by which a psychiatrist, psychologist, or other mental health clinician mistakes his or her patients belief in real events for delusion and diagnoses accordingly. ... Monothematic delusions are delusions that only concern one particular topic. ... For other senses of this word, see paranoia (disambiguation). ... The Paranoia Network is a self-help organization. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...

Further reading

  • Bell, V., Halligan, P.W. & Ellis, H. (2003) Beliefs about delusions. The Psychologist, 16(8), 418-423. Full text
  • Blackwood NJ, Howard RJ, Bentall RP, Murray RM. (2001) Cognitive neuropsychiatric models of persecutory delusions. American Journal of Psychiatry, 158 (4), 527-39. Full text
  • Coltheart, M. & Davies, M. (2000) (Eds.) Pathologies of belief. Oxford: Blackwell. ISBN 0-631-22136-0
  • Munro, A. (1999) Delusional disorder. Cambridge: Cambridge University Press. ISBN 0-521-58180-X
  • Persaud, R. (2003) From the Edge of the Couch: Bizarre Psychiatric Cases and What They Teach Us About Ourselves. Bantam. ISBN 0-553-81346-3.

References

  1. ^ Myin-Germeys, I., Nicolson, N.A. & Delespaul, P.A.E.G. (2001) The context of delusional experiences in the daily life of patients with schizophrenia. Psychological Medicine, 31, 489-498.
  2. ^ Spitzer, M. (1990) On defining delusions. Comprehensive Psychiatry, 31 (5), 377-97
  3. ^ Young, A.W. (2000).Wondrous strange: The neuropsychology of abnormal beliefs. In M. Coltheart & M. Davis (Eds.) Pathologies of belief (pp.47-74). Oxford: Blackwell. ISBN 0-631-22136-0
  4. ^ Jones, E. (1999) The phenomenology of abnormal belief. Philosophy, Psychiatry and Psychology, 6, 1-16.
  5. ^ Maher, B.A. (1988) Anomalous experience and delusional thinking: The logic of explanations. In T. Oltmanns and B. Maher (eds) Delusional Beliefs. New York: Wiley Interscience. ISBN 0-471-83635-4
  6. ^ Kuhn, T. (1962) The Structure of Scientific Revolutions. University of Chicago Press. ISBN 0-226-45808-3
  7. ^ David, A.S. (1999) On the impossibility of defining delusions. Philosophy, Psychiatry and Psychology, 6 (1), 17-20

  Results from FactBites:
 
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Delusion - Wikipedia, the free encyclopedia (851 words)
A delusion is commonly defined as a fixed false belief and is used in everyday language to describe a belief that is either false, fanciful or derived from deception.
Delusions typically occur in the context of neurological or mental illness, although they are not tied to any particular disease and have been found to occur in the context of many pathological states (both physical and mental).
In other cases, the delusion may be assumed to be false by doctor or psychiatrist assessing the belief, because it seems to be unlikely, bizarre or held with excessive conviction.
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