Delusional jealousy

• delusions of love characterized by the patient's conviction that another person is in love with him or her

• delusions of guilt, unworthiness, and poverty which may sometimes reach the degree of 'nihilistic delusions' in which the patient believes that real world has disappeared completely

• grandiose delusions in which patients are convinced that they have great talents, are prominent in society, or possess supernatural powers

• hypochondriacal delusions founded on the conviction of having a serious disease.

The mood state when delusional ideas emerge favours certain themes. Delusions of guilt, or unworthiness, and hypochondriacal delusions are strongly linked with depression. Grandiose and erotic delusions generally occur in euphoric, excited, or manic states. Delusions of persecution and jealousy emerge most frequently from suspicious mood states or a delusional atmosphere, but they are occasionally observed in depressed subjects.

This broad thematic classification has been supplemented by categories taking into account specific contents:

• religious delusions which occur most commonly with grandiose delusions or delusions of guilt

• delusions of infestation which are a subtype of hypochondriacal delusions and are characterized by the conviction of infestation by small organisms

• delusional misidentification in which the patient believes, on the basis of a delusional percept, that a perceived person has been replaced by an imposter, or in which he is convinced that another person has been physically transformed into his own self

• delusions of control in which the patient experiences sensations, feelings, drives, volition, or thoughts as made or influenced by others (this type of delusion occurs in schizophrenia and is believed to result from cognitive dysfunction consisting of a failure of the system which monitors willed intentions (l^).

The structure of delusions

The structure of delusions contains three criteria.

1. The alternatives 'logical' or 'paralogical' indicate whether or not the connection of ideas is consistent with logical thinking.

2. The notions 'organized' or 'unorganized' indicate whether or not the delusional ideas are integrated into a formed concept. Highly organized logical delusional edifices are known as 'systematized delusions'.

3. The third criterion concerns the relationship between delusional reality and reality:

• in polarized delusions the delusional reality is inextricably intermingled with actual facts

• if the delusional beliefs and reality exist side by side without influencing one another, we speak of juxtaposition

• in autistic delusions the patient takes no account of reality and lives wholly in a delusional world.

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