Dr. Vaibhav Dubey
MBBS, MD (Psychiatry)
Dr Vaibhav Dubey is a well known young psychiatrist in the city of lakes, Bhopal, India.
What is Delusion?Posted by : Dr. Vaibhav Dubey
A delusion is a fixed, false personal belief held
with absolute conviction despite all evidence
to the contrary. The belief is outside the
person’s normal culture or subculture and
dominates their viewpoint and behavior.
Delusions may be described in terms of their
content (e.g. delusions of persecution or
grandeur). They can be mood congruent (the
content of delusion is appropriate to the mood
of the patient), or mood incongruent.
Delusions are described as systematized if they
are united by a single theme.
A primary delusion arises fully formed
without any discernible connection with
previous events (also called autochthonous
delusions), e.g. “I woke up and knew that my
daughter was the spawn of Satan and should
die so that my son could be the new Messiah”.
Secondary delusions can be understood in
terms of other psychopathology, for example
hallucinations: “The neighbors must have
connected all the telephones in the building;
that’s why I can hear them all the time”.
The term delusional mood is slightly
confusing in that it does not describe an
abnormal belief, but refers to an ill-defined
feeling that something strange and threatening
is happening which may manifest as perplexity,
uncertainty or anxiety. This may precede a
primary delusion or a delusional perception,
which involves a real perception occurring
almost simultaneously with a delusional
misinterpretation of that perception, e.g. “I saw
the traffic lights change from red to green and
knew that I was the rightful heir to the throne of
Overvalued ideas are unreasonable and
sustained intense preoccupations maintained
with a strong emotional investment but less
than delusional intensity. The idea or belief
held is demonstrably false and not usually held
by persons from the same subculture.
Delusions may be classified in terms of their
content, for example delusions of...
Persecution An outside person or force is in
some way interfering with the sufferer’s life or
wishes them harm, e.g. “The people upstairs
are watching me by using satellites and have
poisoned my food”.
Reference The behavior of others, objects, or
broadcasts on the television and radio have a
special meaning or refer directly to the person,
e.g. “A parcel came from Sun Alliance and the
radio said that ‘the son of man is here’, on a
Sunday, so I am the son of God”.
Control The sensation of being the passive
recipient of some controlling or interfering
agent that is alien and external. This agent can
control thoughts, feeling and actions (passivity
experiences), e.g. “I feel as if my face is being
pulled upwards and something is making me
laugh when I’m sad”.
Grandeur Exaggerated belief of one’s own
power or importance, e.g. “I can lift mountains
by moving my hands, I could destroy you!”.
Nihilism Others, oneself, or the world does not
exist or is about to cease to exist (often called
Cotard’s syndrome), e.g. “The inside of my
tummy has rotted away. I have no bowels”.
Infidelity One’s partner is being unfaithful
(also known as delusional jealousy or the
Doubles A person known to the patient, most
frequently their spouse, has been replaced by
another (also known as Capgras’ syndrome or,
confusingly, ‘illusion’ of doubles).
Infatuation A particular person is in love with
the patient (also known as erotomania or de
Somatic Delusional belief pertaining to part of
the person’s body, e.g. “My arms look like
they’ve been melted and squashed into a