American Medical Association Family Medical Guide - American Medical Association [469]
• Being persecuted
• Having a serious medical condition or physical defect
• Believing that a spouse or sex partner is unfaithful
• Believing that a celebrity or person of higher status loves him or her
• Having a special, undiscovered talent, power, or knowledge
Some people have more than one type of delusion. In all other aspects of their life, people with delusional disorder seem relatively normal, although they are often described as cold and aloof. They easily become argumentative and uncompromising, especially when confronted with their erroneous beliefs. Problems may arise when the person decides to act on his or her belief—for example, by stalking an imagined lover or suing someone the person thinks is ruining his or her reputation. People with delusional disorder are only rarely violent or dangerous, but may be perceived as such because they are often angry.
Diagnosis
No test is available that can diagnose delusional disorder. Doctors diagnose the disorder when a person has had the delusional beliefs for at least 3 months and does not have any psychotic symptoms such as hallucinations or other thought abnormalities that would indicate schizophrenia.
Treatment
It can be very difficult to bring a person with delusional disorder in for treatment because he or she will vigorously deny any need for help. The best way to persuade an affected person to seek treatment is to suggest that he or she get help for depression or anxiety instead of for the delusion. Hospitalization usually is not necessary—in fact, it may increase the person’s distrust and feelings of persecution. Antipsychotic drugs are the primary treatment for delusional disorder and usually are taken indefinitely. Psychotherapy may be helpful, especially with a supportive therapist who can help the person see how his or her delusional beliefs create problems in his or her life. Group therapy is not recommended for people with delusional disorder because other people usually don’t share their beliefs. With treatment, some people with delusional disorder recover fully, and others experience episodes of delusions alternating with periods of normalcy. Others remain delusional even with treatment.
Developmental Disorders
Attention deficit and other developmental disorders are not as well understood as many other diseases. These disorders are thought to be caused by a combination of factors that can affect the development of the brain—including genes, exposure during fetal development to drugs taken by the mother, abnormal development of the brain, or brain injuries at birth or during early childhood.
Attention Deficit Disorders
Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are developmental brain disorders characterized by distinctive and consistent behaviors, including inattentiveness, distractibility, impulsiveness, and, in the case of ADHD, hyperactivity (excessive movement or restlessness). The official diagnosis of the condition is ADHD, but three subtypes are medically recognized—predominantly inattentive, predominantly hyperactive/impulsive, and a combined type. Boys and men more frequently have the hyperactive type of attention deficit disorder; girls and women more often have the inattentive form.
About 4 to 6 percent of the US population have an attention deficit disorder. Although the popular conception is that the condition affects only children, an attention deficit disorder can extend into adulthood. One half to two thirds of affected children continue to have problems as adults. The characteristic behaviors usually appear before age 7 and are much stronger than the normal distractibility and impulsiveness that are common in childhood.
Attention deficit is not a new disorder—its characteristic behaviors have been recognized since the early 1900s. In the past, many people with the condition were diagnosed with minimal brain damage. Although the underlying causes of the neurologic problem remain unknown,