example of a mood-incongruent delusion would be a
depressed person’s belief that his or her thoughts are
being controlled by the Central Intelligence Agency.
For a belief to be considered a delusion, it must be
pathological in nature.Disorders Associated With Delusions
Delusions are symptoms of several psychological dis-
orders and are indicative of a psychotic mental illness.
Along with hallucinations, delusions are the most rec-
ognizable symptoms of schizophrenia. However, the
presence of delusions alone is not sufficient to warrant
a diagnosis of schizophrenia. In schizophrenia, the
delusions can be either bizarre or nonbizarre.
Delusions are the predominant symptom of delu-
sional disorder, which is a mental disorder in which the
person holds one or more nonbizarre delusions in the
absence of any other psychopathology. In addition, the
person must not have ever met any of the diagnostic
criteria of schizophrenia. In many instances, a person
with delusional disorder can function normally in most
aspects of life, and the only indication of mental illness
is the behavior that results directly from the delusional
belief. For example, a person could believe that he or
she is being spied on through the electrical outlets in
his or her house, so that person covers all the outlets
with electric tape. With the exception of this behavior,
which is directly related to the delusional thought, the
person is able to maintain a job and relationships.
Historically, delusional disorder was referred to as
paranoia.
Delusions have also been associated with demen-
tia, severe depression, and the manic phase of bipolar
disorder.Types of Delusions
There are several different types of delusions, such as
erotomanic delusions, delusions of grandiosity, jeal-
ous delusions, persecutory delusions, delusions of
control, nihilistic delusions, delusions of guilt or sin,
somatic delusions, and delusions of reference.EErroottoommaanniicc DDeelluussiioonnss
An erotomanic delusion is a delusion in which the
individual believes that he or she has a special, loving
relationship with another person, who is usually a
famous individual or someone of high standing. Thesubjects of delusions are often popular media figures
such as politicians, actors, and singers. In certain
instances, the delusional individuals believe that the
subject of their delusion is communicating secret love
messages to them through signals such as gestures and
body posture. As part of the delusion, the delusional
individuals believe that their feelings are reciprocated by
the subject of their delusion. In the case of celebrities,
these gesture are usually transmitted to the delusional
individual through the radio or television. In most cases,
the subject of the delusion has no contact with, or aware-
ness of, the delusional individual. Erotomanic delusions
are most often found in individuals diagnosed with
schizophrenia or delusional disorder.
Erotomanic delusions can lead to stalking or other
potentially dangerous behaviors. In some extreme
cases, the delusional individual has broken into the
house of the subject of the delusion and even killed
the person. A number of widely reported crimes have
been associated with erotomanic delusions: in 1989,
Rebecca Schaeffer, a young actress, was shot and
killed at her home by an individual who had an ero-
tomanic delusion about her. Also, it was reported that
the assassination attempt on the former U.S. president
Ronald Reagan was driven by an erotomanic delusion:
John Hinckley Jr. shot Reagan in the deluded belief
that this action would cause the actress Jodie Foster to
publicly declare her love for him.
There is some controversy about the prognosis for
those who are diagnosed with erotomanic delusions.
According to some researchers, such individuals
respond poorly to treatment, while other researchers
view the delusions as symptomatic of an underlying
psychotic disorder that generally will respond to
antipsychotic medications and supportive psychother-
apy. There is some evidence that individuals with
delusional disorder have poor compliance with treat-
ment, as they are often so enthralled with the subject
of their delusion that they cannot be persuaded to take
medications that may diminish the symptoms.GGrraannddiioossee DDeelluussiioonnss
Individuals who have delusions of grandiosity
often have an exaggerated sense of self-importance or
inflated worth. They may be convinced that they pos-
sess superior knowledge or skills or that they have a
special relationship to a deity or a celebrity. In certain
cases, the delusional individuals may actually believe
that they themselves are a deity (such as Jesus Christ)Delusions——— 193D-Cutler (Encyc)-45463.qxd 11/18/2007 12:41 PM Page 193