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View Full Version : The Case of the Delusional Patient


JasonM
05-04-2008, 07:19 PM
The diagnostic criteria for a delusional disorder is as follows:

A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration.

B. The criteria for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme.

C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.

D. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Suppose you're a psychiatrist. Someone comes to your office with the belief that they have a delusional disorder that's lasted for at least a month, and criteria B through E have been met. Do they have a delusion?

Suppose that it's a delusion. Then they have a delusional disorder. However, the belief is that they have a delusional disorder, so it can't be a delusion.

Suppose that it's not a delusion. Then they don't have a delusional disorder. However, since they believe that they have a delusional disorder, it has to be a delusion.

Therefore, since the determination of whether or not it is a delusion is critical for making a diagnosis, how can you come to any conclusion?

(Does anyone now want to go to their doctor presenting this symptom?)

sriv
05-04-2008, 08:04 PM
The practice of psychiatry is all smoke and mirrors. In APA (American Psychiatrist Association), a bunch of well-known doctors of the field have a conference every year or two and they VOTE on whether a disorder is considered a disorder, what to name it, the criteria. That's stupid.

Erika Redmark
05-04-2008, 08:08 PM
If you had the delusion that you were having delusions, then wouldn't your delusion make you have other delusions? So you would also have normal delusions? I can't picture what having a delusion of delusions, with nothing substantive about the delusions, would be like…