Delusion
Presentation Hasan Ismail Alabsi
OUTLINE PRESENTATION
1- definition of delusion
2- Pathophysiology of delusion
3- types of Delusion
4- causes of delusion
5- sign and symptoms of delusion
6- treatment of delusion
7- nursing process of delusion
DEFINITION OF DELUSION
A delusion is a belief that is clearly false and
that indicates an abnormality in the affected
person's content of thought. The false belief is
not accounted for by the person's cultural or
religious background or his or her level of
intelligence
PATHOPHYSIOLOGY
OF DELUSION
The pathophysiology of delusional disorder remains
unknown, although some preliminary evidence
indicates that polymorphisms in genes coding for
dopamine receptors (DRD3 and DRD4) are
associated with the disorder.
TYPES OF DELUSION
Erotomanic
Erotomanic: People with this type of delusional
disorder believe that another person, often
someone important or famous, is in love with
them. They may attempt to contact the person
of the delusion and engage in stalking behavior.
GRANDIOSE
Grandiose: People with this type of delusional disorder have
an overinflated sense of self-worth, power, knowledge or
identity. They may believe they have a great talent or have
made an important discovery.
JEALOUS
Jealous: People with this type of delusional disorder
believe that their spouse or sexual partner is
unfaithful without any concrete evidence.
PERSECUTORY
Persecutory: People with this type of delusional
disorder believe someone or something is
mistreating, spying on or attempting to harm them
(or someone close to them). People with this type of
delusional disorder may make repeated complaints
to legal authorities.
SOMATIC
: People with this type of delusional disorder
believe that they have a physical issue or
medical problem, such as a parasite or a bad
odor.
BIZARRE
Bizarre: These delusions involve believing something
impossible in our reality, such as aliens taking over your
friend's body.
Thought broadcasting
Thought broadcasting: The idea that your thoughts are
being transmitted and heard through public mediums like
TV, radio, or the internet.
Thought insertion
Thought insertion: The idea that thoughts are
being imposed on you by outside forces.
Ideas of reference
- Ideas of reference are false beliefs that random
or irrelevant occurrences in the world directly
relate to oneself
nihilistic
He would verbalize that his organs are no more
working, his brain has stopped functioning, and his
house has developed cracks and is going to fall down
Mixed
Mixed: Two or more of the types of delusions
listed above.
SIGN AND SYMPTOMS OF DELUSION
Behavioral symptoms:
Antagonistic behavior, such as filing lawsuits or sending many letters of
protest
Aggressive behavior towards others that is consistent with delusions
Other behaviors that are consistent with delusions, such as scratching one’s
skin if one believes one’s body is infested with insects
Poor occupational functioning directly related to the delusional belief
Relative lack of impairment in functioning other than that caused by the
delusion
Psychosocial symptoms:
Social difficulties related to one’s delusion(s)
Tension in romantic relationships related to the delusion(s)
Irritability
SIGN AND SYMPTOMS OF DELUSION
Cognitive symptoms:
Experiencing a delusion or delusions
Poor insight into irrationality of one’s delusional belief(s)
Believing that others are attempting to harm the person (persecutory type)
Belief that others are in love with the person (erotomanic type)
Belief that one has great talents or a history of important achievements
(grandiose type)
Believing that one’s spouse or significant other is unfaithful (jealous type)
Belief that one’s body has a foul odor, is malfunctioning or misshapen, or is
infested (somatic type)
Other delusional belief (mixed or unspecified type)
Lack of bizarre or odd beliefs other than the delusion
CAUSES OF DELUSION
Generic factors: The fact that delusional disorder is more common
in people who have family members with delusional disorder or
schizophrenia suggests there might be a genetic factor involved.
Biological factors: Researchers are studying how abnormalities of
certain areas of your brain might be involved in the development of
delusional disorder.
Environmental and psychological factors: Evidence suggests that
delusional disorder can be triggered by stress. Alcohol use disorder
and substance use disorder might contribute to the condition
TREATMENT OF DELUSION
Treatment for delusional disorder most often includes psychotherapy (talk
therapy) and medication, but delusional disorder is highly resistant to
treatment with medication alone.
People with delusional disorder often don’t seek treatment for the
condition on their own because most people with delusional disorder
don’t realize their delusions are problematic or incorrect. It’s more
likely they’ll seek help due to other mental health conditions such as
depression or anxiety.
People with severe symptoms or who are at risk of hurting
themselves or others might need to be admitted to the hospital
until the condition is stabilized.
TREATMENT OF DELUSION
Individual psychotherapy: This type of therapy can help a person recognize and
correct the underlying thinking that has become distorted.
Cognitive behavioral therapy (CBT)
Family-focused therapy
First-generation (“typical”) antipsychotics
chlorpromazine (Thorazine®),
fluphenazine (Prolixin®)
Second-generation (“atypical”) antipsychotics
risperidone (Risperdal®), clozapine
(Clozaril®)
NURSING ROLE FOR DELUSIONAL DISORDER
Don't argue or reject.
Try to keep them engaged.
Encourage to practice some relaxation techniques.
Use distractions, exercising, hobbies, saying stop.
Calming by a glass of water or counting.
Be tactful in approach.
Do not express approval.
Acknowledge feelings or fear.
Reassure and encourage.
Explain clearly what you are doing and why.
Maintain consistency.
Keep communication open and non judgmental.
Listen understand and respect their feelings.
Nursing diagnosis
Risk for Self-directed or Other-directed Violence
related to delusional thinking and hallucinatory
experiences .
Nursing outcome
Patient will be appear Safety .
Nursing intervention
Monitor patient for behaviors that indicate
increased anxiety and agitation.
Collaborate with patient to identify anxious
behaviors as well as the causes.
Nursing diagnosis
Disturbed Thought Processes related to
perceptual and cognitive distortions, as
demonstrated by suspiciousness, defensive
behavior, and disruptions in thought .
Nursing outcome
Patient will be show the Differentiation
Between Delusions and Reality .
Nursing intervention
Provide patient with honest and consistent
feedback in a nonthreatening manner.
Avoid challenging the content of patient's
behaviors.
Focus interactions on patient's behaviors.
Nursing diagnosis
Ineffective Coping related to misinterpretation of
environment and impaired communication ability .
Nursing outcome
Patient will be show the Improving Coping with
Thoughts and Feelings .
Nursing intervention
Encourage patient to express feelings.
Focus on patient's feelings and behavior.
Nursing diagnosis
Activity Intolerance related to adverse reactions
to psychopharmacologic drugs .
Nursing outcome
Patient will be show the Improving Activity
Tolerance .
Nursing intervention
Assess patient's response to prescribed
antipsychotic drug.
Collaborate with patient and occupational and
physical therapy specialists to assess patient's
ability to perform ADLs.
Nursing diagnosis
Social Isolation related to an inability to trust .
Nursing outcome
Patient will be show the Promoting Socialization .
Nursing intervention
Encourage patient to talk about feelings in the
context of a trusting, supportive relationship.
Allow patient time to reveal delusions to you
without engaging in a power struggle over the
content or the reality of the delusions.
Referance
Encourage patient to talk about feelings in the context of a trusting,
supportive relationship.
Allow patient time to reveal delusions to you without engaging in a
power struggle over the content or the reality of the delusions.
[Link]
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disorder#symptoms-and-causes
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