Course and prognosis

Without treatment this is a chronic illness which is likely to worsen gradually over time. Forensic complications<8M2)

Males who irrationally act out their erotomanic delusions are usually diagnosed as schizophrenic but some prove to have delusional disorder. Often the overt behaviour is in the nature of harassment, but even without violence the individual's persistent intrusiveness and incorrigibility can be thoroughly alarming to the victim, who is bewildered by the situation and by the other's accusations of duplicity. (83)

Severely aggressive behaviour can lead to assault, kidnapping, and even murder, sometimes of the love object or perhaps an acquaintance of the latter who is viewed as a rival. A manifestation which has gained much recent publicity is that of victim stalking, and in a considerable number of cases the victim has no idea who is carrying out the stalking.

While women are generally less prone to aggressive acting out of their delusions, they may sometimes demonstrate their false beliefs in devastating ways. For example, a deluded woman may claim publicly that a physician, counsellor, or teacher has demonstrated strong erotic feelings towards her. This belief may be the result of a delusional memory. If she has an undeteriorated personality, is coherent, totally believes her own story, and presents it with typical vehemence and persistence, it may be virtually impossible to persuade the public and the authorities that the accusations are totally false. Any professional person dealing with deluded patients must be aware of abnormal transference emotions that may arise in the patient during treatment, usually of a heterosexual nature but sometimes homosexual. Great circumspection is then required and the therapist must immediately seek collegial help in dealing with such a situation.

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