Delusions: what are they, types and differences with hallucinations?

This symptom is frequent in psychotic and paranoid disorders.

It is common that on some occasion, especially under high levels of stress, we find ourselves with the firm belief that someone is watching us, that someone is following us or that someone is talking about us, although this is not true.

However, when these ideas flood the person's mind and he/she is not able to see the reality, we can speak of the well-known delusions. Throughout this article we will deepen about the nature of this experience, as well as its causes, types and differences with other false beliefs.

What are delusions?

Within the scope of the psychopathology it is understood by delirium a false belief or idea that the patient accepts with total conviction.even though external evidence to the contrary may show the contrary. Although it has not yet been possible to generate a fully accepted and satisfactory description of this concept, the above description would be one of the most approximate.

Despite its pathological characteristics, delirium is not considered a mental disease or disorder. is not considered a mental disease or disorder per se, but rather a symptom of a mental disorder.Rather, it would be a symptom of a variety of psychological conditions such as bipolar disorder, schizophrenia, mania or psychotic depression.

During the course of delirium the mental state of the person undergoes a great number of changes. These cause the patient to experience feelings of confusion and behavioral disturbances..

Other manifestations or problems typical of delirious states are:

• Abrupt changes between states of lucidity and unconsciousness.
• Loss of contact with reality.
• Alteration of attention and memory.
• Emotional swings.
• Problems in the control of the musculature.
• Sleep disturbances.

Diagnostic criteria

Although, as specified in the previous point, delusions do not constitute a clinical disorder, but are part of a larger pathological picture. However, they must meet a series of special and specific requirements in order to be considered as such.

Some authors and researchers have developed a series of defining constructs of delirium. These dimensions or constructs are given in the form of a continuum starting from what is considered a normal belief. from what is considered a normal belief, up to a pathological oneThey are key to differentiate delusions from other types of beliefs or misconceptions. These characteristics are the ones we will see below.

1. Fixed and unchangeable beliefs or ideas

The delusion must be maintained over timeIt is unlikely, if at all, that it can be modified or corrected regardless of the evidence against it.

2. Intense conviction

A delusion is a firmly held idea. That is to say, the person believes blindly in an idea or concrete event.

3. Lack of cultural support

It is necessary to specify that the idea that the patient maintains cannot be shared by other people or cultural group.. This means that for the belief to be considered irrational it cannot be shared or accepted by the rest of the society of reference.

4. Excess of concern

Unlike other types of false or irrational beliefs, in delusions the person presents a great preoccupation or rumination of the delusional idea, which involves an important psychological wear and tear since the patient thinks about it obsessively.

5. Degree of plausibility

This last criterion refers to the degree of probability that the idea could be real. This degree of plausibility may vary from one delusion to another. This means that although in some cases it is easy to detect the impossibility of the delusional idea, in others it may be totally plausible but false, in others they can be totally plausible but false..

What causes them?

Delusions and delusional ideas have as their origin a series of mental and psychological disorders that accompany and shape them. These psychological conditions are:

• Paranoid disorders.
• Paranoid, schizoid and schizotypal personality disorders.
• Schizophrenias.
• Affective disorders such as psychotic depression and mania.

However, they can also may also be part of other alterations of organic origin derived from the derived from drug and alcohol abuse, as well as from detoxification processes and as a secondary reaction to certain drugs.

What types of delusions are there?

Despite the large number of existing delusions, they can be categorized and classified according to their content. The following are some of the most frequent and well known.

1. Paranoid delirium

In the case of paranoid delusions, the person is convinced that a person or a group of people is convinced that a person or group wants to cause him/her some kind of harm, whether physical, psychological or psychological.either physical, psychological or social. This delirium can take the form of the idea that others want to kill him or her or that someone is trying to drive him or her crazy.

2. Persecution delirium

People suffering from persecution delirium firmly affirm that someone is persecuting them, or even that there is a conspiracy against them. This persecution can be either on the street, directly, or in a more veiled way: patients may think that their home is being broken into, that their mail is being opened, or that their mobile devices or computers are being searched.

3. Delusions of grandeur

The content of this delirium manifests itself in the form of excessive self-evaluation of the patient's abilities and powers; the patient of the patient; who attributes special capacities to himself as well as a great consideration of his own identity.

4. Delusion of reference

As its name suggests, in the delirium of reference the patient believes that certain events, phrases or statements of other people have to do with him or her or have a special significance that has to do with him or her.

It is common for these patients to think that both the media and other people are sending them all kinds of messages.

5. Somatic delirium

In this last case, the patient shows the conviction that he/she is sick or that his/her body is getting sick.. In the same way, he/she may perceive a series of false changes or abnormalities in his/her body. These are only a small sample of what in reality is a long list of delusions and delirious ideas.

6. Other

Other delusions also quite well known are:

• Delusions of control.
• Metacognitive delusion.
• Delusion of guilt or sin.
• Celotypical delirium.
• Delusion of false identification.
• Erotomanic delirium.

What is the difference between a delirium and a hallucination?

The fact that in many occasions they are presented together and share certain characteristics makes delusions and hallucinations makes that delusions and hallucinations are frequently confused.. However, once we know what delusions consist of, it is much easier to differentiate between them.

Unlike delusions, hallucinations are an original product of the person's mind. That is, they do not really exist either in reality or in the person's external world. Moreover, just as a delusion consists of an idea, hallucinations can be auditory, visual, tactile or even gustatory experiences. Therefore, the main difference between the two concepts is that the hallucination is a totally original and invented product of the person's mind, while the delusion would be an auditory, visual, tactile or even gustatory experience. delirium is a distortion of an external stimulus..

For example, in a delirium the person can perceive a real stimulus such as the radio; however, the person's mind distorts the message or interprets it as a kind of communiqué for him. While in hallucination, the auditory stimulus would be completely invented by the mind, and could not be perceived by anyone else.

Delirium would consist of a belief or erroneous interpretation of reality based on a real fact, situation or stimulus. However, both concepts have a point in common. In this case it is that patients are fully convinced of the reality and veracity of their ideas or beliefs.