In schizophrenia, sufferers can suffer from a wide variety of delusions. UFOs from outer space, work for the secret service and voices that ask you to end the senseless life: These are common delusions. But when does a delusion occur and how at the mercy of it is one?
What is a delusion?
“You must be crazy” or “What you’re just making up” are just two of many phrases that are meant to express that the other person obviously perceives a situation differently than you do. But the deviating perception of a fact does not automatically mean that delusions are present: Only in delusion is reality morbidly and uncorrectably misjudged – a change of point of view (“maybe my opinion is not correct”), which is possible in discussion between healthy people, becomes impossible; delusion is a rigid and substantively false conviction.
Definition of delusions
Delusions belong to the thought disorders and are often embedded in a complex delusional reality that is only apparent to the sufferer. This delusional reality may coexist with the actual reality or completely dominate the thinking of the sufferer. In the delusion, persons, memories, ideas and moods are misjudged and the delusional perception often becomes life-determining. For the affected person, this reality is uncorrectably correct – he is not able to critically question his ideas. This leads to isolation in his delusion, which in turn supports the pathological ego-centeredness that occurs in the delusion. A delusion is often preceded by a delusional mood in which the world appears threatening to the affected person.
Schizophrenia: delusions and delusional system.
Delusional perception causes day-to-day occurrences to be “reinterpreted.” When this happens with events from earlier times, they are called delusional memories. Delusions, of which working for a secret service is one of the best known, are embedded in a delusional system – the delusional work that is done serves, among other things, to explain all delusions (so-called explanatory delusion). Common subjects for delusions are:
- Persecutory thoughts
- Guilt and sin thoughts
- A massive focus on oneself (relationship delusions, “everything is happening because of me” and impairment delusions, “everything is meant to harm me”)
- Love and jealousy
In addition, there is the size delusion and, conversely, the smallness or nothingness delusion; furthermore, the dermatozoa delusion, in which the sufferer is convinced that animal pathogens have penetrated through his skin, and the impoverishment delusion.
Delusions in schizophrenia
Some delusion themes typically occur in certain disorders – in schizophrenia, for example, the relationship delusion, the impairment delusion, the persecution delusion, the dermatozoa delusion, and the delusions of grandeur. In order to get a comprehensive picture of the manifestation of the delusion, the treating physician makes use of the so-called psychopathological findings. The affected person is usually unable to perceive the delusions, to compare the course of his thought processes with that of healthy phases of life, and to name the sometimes very distressing changes.
When do delusions occur?
Although delusions also occur with brain tumors or a brain infection, after taking medication or drugs, these are rather rare causes. Delusions of jealousy in chronic alcohol dependence or delusional misrecognition of people in dementia occur, as do delusional depressions. In these cases, delusions occur that fit well with the depressive mood, such as delusions of impoverishment or sin, hypochondriacal delusions, and delusions of littleness or nothingness. Here, then, the underlying illness is the cause of the delusion.
Schizophrenia and its causes
Delusions are most common, however, in schizophrenia, one of the most common mental illnesses. The likelihood of developing schizophrenia at some point is one percent worldwide. The causes of schizophrenic disorder consist of a web of psychosocial and genetic-biological factors. Acute stressful situations can lead to the onset of the disease if the person is predisposed to it. Dopamine plays a central role in the development of psychotic symptoms by flooding the brain systems responsible for emotions.Schizophrenics have more dopamine and dopamine receptors, which may be responsible for symptoms such as delusions, hallucinations, and paranoia.
Symptoms in schizophrenia
Schizophrenia is said to occur when any of the following symptoms persist for at least one month:
- Thought aloudness, thought invocation, thought withdrawal, or thought spreading (so-called ego disorders).
- Delusions of control, delusions of influence, sense of being made, delusions (so-called content thought disorders).
- Commenting, dialogue or other voices coming from a part of the body (so-called auditory hallucinations).
- persistent, culturally inappropriate, or completely unrealistic (bizarre) delusions (for example, being able to control the weather or being in contact with aliens)
or any two of the following symptoms: - Persistent hallucinations of any sensory modality.
- Thought tearing off or insertions into the flow of thought, resulting in disjointedness, talking off topic, or word neologisms (so-called formal thought disorders)
- Agitation, postural stereotypies or waxy pliability, negativism (it is done after prompting contrary), mutism (silence) and stupor (so-called catatonic symptoms)
- Striking apathy, impoverishment of speech, flattened or inadequate affect, mostly with social withdrawal and reduced social performance (so-called “negative” symptoms)
- Very clear and consistent changes in certain comprehensive aspects of behavior, which manifests itself in aimlessness, inertia, an attitude “lost in himself” and social withdrawal
