Describe the type of delusion. Differentiate between delusion and hallucination.

Delusions: A false, unshakeable belief, which is not amenable to reasoning and is not in keeping with
the patient's sociocultural and educational background.

Primary (Autochthonous) delusion is one that appears suddenly and with full conviction, but without
any previous events leading up to it. Such delusions are suggestive of schizophrenia.

Secondary delusions can be understood as derived from some preceding morbid experience.

Delusional mood: Occasionally, when a person first develops a delusion, the first experience is a
change of mood, often a feeling of anxiety with the foreboding that some sinister event is about to
take place, and the delusion follows. In German this change of mood is called Wahnstimmung, a
term usually translated as delusional mood.

Delusional perception: In some occasions when a person first develops a delusion, the first change
may be attaching a new significance to a familiar percept without any reason. For example, a new
arrangement of objects on a colleague's desk may be interpreted as a sign that the patient has been
chosen to do God's work. This is called delusional perception.

Delusion of grandeur: An individual's exaggerated conception of his importance, power or identity, a

belief that he is somebody special, or is born with a special mission in life, or is related to the most
important people of his time. (e.g., “I am Jesus Christ”).

Delusion of persecution: A belief that he is being attacked, harrassed, spied, cheated or conspired
against. (e.g., “The FBI has ‘bugged’ my room and intends to kill me.” “I can’t take a shower in this
bathroom; the nurses have put a camera in there so that they can watch everything I do”).

Delusion of reference: It is the delusion that events, objects, behaviour of others have got a
particular or unusual significance for oneself, usually of a negative nature. For instance, the person
may falsely believe that others are talking about him (such as, the belief that people on television or
radio are talking about the person).

Delusion of control: This refers to the belief that the patient's will, thoughts or feelings are being
controlled by external forces. (e.g., “The dentist put a filling in my tooth; I now receive transmissions
through the filling that control what I think and do”).

Delusion of infidelity (Delusion of jealousy): This is the delusion that one's lover is unfaithful to him/
her.

Delusion of guilt: Belief that one is a sinner and is responsible for the ruin of his family or society.
Somatic delusion: Belief involving functioning of the body. For example, belief that the brain is
rotting or melting.

Nihilistic delusion: The individual has a false idea that the self, a part of the self, others, or the world
is nonexistent (e.g., “The world no longer exists.” “I have no heart.”). Most commonly seen in major
depressive episode.

Somatic Delusion. The individual has a false idea about the functioning of his or her body (e.g., “I’m
70 years old and I will be the oldest person ever to give birth. The doctor says I’m not pregnant, but I
know I am.”).
Erotomania: A delusional belief that the other person is deeply in love with him/her. The supposed
lover is usually inaccessible and of much higher social status (also known as ClerambaultKandinsky
Complex).

Mood-incongruent delusion: Delusion with content that has no association to mood or is mood
neutral (for example a depressed patient has delusions of thought control or thought broadcasting).

Mood- congruent delusion: Delusion with mood appropriate content (for example, a depressed
patient believes that he is responsible for the destruction of the world).

Systematized delusion: False belief or beliefs united by a single event or theme.

Bizarre delusion: An absurd, totally implausible, strange false belief in a person's mind.

Delusion Hallucination
Type of disorder Disorder of thought Disorder of Perception
Definition A false, unshakeable belief, which is A false sensory perception in the
not amenable to reasoning and is absence of an actual external
not in keeping with the patient's stimulus.
sociocultural and educational
background
Types
Delusions mostly occur due to
Cause underlying psychological or
Hallucinations can occur as a
result of sleep deprivation,
neurological disorders alcohol withdrawal or drug
abuse as well as secondary to
psychological conditions like
schizophrenia.

Sympto A person who is getting

delusions generally has a
A person who is experiencing
hallucinations may hear
ms strong belief which may or voices talking to him, so he
may not be based on any will tend to respond to those
true perception. Also, faulty voices which will often
delusions can often appear appear as real conversations
irrational or bizarre to people to others around him
around
Delusions often need Hallucinations can be treated
Treatme psychotherapy in combination symptomatically with anti-
nt with drugs like antipsychotics,
antidepressants, and anxiolytics
psychotics alone

Example I cant take the food, someone has I can hear a voice talking to me
fixed poison in it
3. Explain the symptoms and clinical features of obsessive compulsive disorder.

Obsession: Pathological persistence of an irresistible thought or feeling that cannot be eliminated

from consciousness by logical effort; associated with anxiety.

Compulsion: Pathological need to act on an impulse that, if resisted, produces anxiety; repetitive
behavior in response to an obsession or performed according to certain rules, with no true end in
itself other than to prevent something from occurring in the future (the patient fears something bad
will occur in future if he does not indulge in such behaviors).

The manifestations of obsessive-compulsive disorder (OCD) include the presence of obsessions,

compulsions, or both, the severity of which is significant enough to cause distress or impairment in
social, occupational, or other important areas of functioning (APA, 2013).

Clinical Picture

Obsessional thoughts: These are words, ideas and, beliefs that intrude forcibly into the patient's
mind. They are usually unpleasant and shocking to the patient and may be obscene or blasphemous.

Obsessional images: These are vividly imagined scenes, often of a violent or disgusting kind involving
abnormal sexual practices.

Obsessional ruminations: These involve internal debates in which arguments for and against even
the simplest everyday actions are reviewed endlessly.

Obsessional doubts: These may concern actions that may not have been completed adequately. The
obsession often implies some danger such as forgetting to turn off the stove or not locking a door. It
may be followed by a compulsive act such as the person making multiple trips back into the house to
check if the stove has been turned off. Sometimes these may take the form of doubting the very
fundamentals of beliefs, such as, doubting the existence of God and so on.

Obsessional impulses These are urges to perform acts usually of a violent or embarrassing kind, such
as injuring a child, shouting in church etc.

Obsessional rituals: These may include both mental activities such as counting repeatedly in a
special way or repeating a certain form of words, and repeated but senseless behaviors such as
washing hands 20 or more times a day. Sometimes such compulsive acts may be preceded by
obsessional thoughts; for example, repeated handwashing may be preceded by thoughts of
contamination. These patients usually believe that the contamination is spread from object to object
or person to person even by slight contact and may literally rub the skin off their hands by excessive
hand washing.

Obsessive slowness: Severe obsessive ideas or extensive compulsive rituals characterize obsessional
slowness in the relative absence of manifested anxiety. This leads to marked slowness in daily
activities.