Type of delusion (1544/1700)

A 64yo woman has been brought by her son for psychiatric evaluation. She says that she has stopped living with her husband because she is convinced it is someone else posing to be him. What kind of delusions is she suffering from?
a. Delusion of reference
b. Delusion of control
c. Delusion of guilt
d. Delusion of persecution
e. Delusion of doubles































answer E

• The Fregoli delusion, a delusion of doubles,  in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.

• The Capgras delusion is also a delusion of doubles in which a person holds a delusion that a friend, spouse, parent, or other close family member (or pet) has been replaced by an identical-looking impostor. 

• Delusions of persecution or paranoia – Belief that others — often a vague “they” — are out to get him or her. These persecutory delusions often involve bizarre ideas and plots (e.g. “Russians are trying to poison me with radioactive particles delivered through my tap water”).

• Delusions of reference – A neutral event is believed to have a special and personal meaning. For example, a person with schizophrenia might believe a billboard or a celebrity is sending a message meant specifically for them.

• Delusions of grandeur – Belief that one is a famous or important figure, such as Jesus Christ or Napolean. Alternately, delusions of grandeur may involve the belief that one has unusual powers that no one else has (e.g. the ability to fly).

• Delusions of control – Belief that one’s thoughts or actions are being controlled by outside, alien forces. Common delusions of control include thought broadcasting (“My private thoughts are being transmitted to others”), thought insertion (“Someone is planting thoughts in my head”), and thought withdrawal (“The CIA is robbing me of my thoughts”). 

• Delusions of Jealousy (Othello syndrome) Patients possess the fixed belief that their spouse or partner has been unfaithful. Often patients try to collect evidence and/or attempt to restrict their partner’s activities.

• Erotomanic Delusions (De Clérambault syndrome) Patients present with the belief that some important person is secretly in love with them. 

• Nihilistic delusions: This is a false belief associated with the nonexistence of the “self,” specific body parts, or the world.  Another variation of a nihilistic delusion could be that the self, body parts, and/or the world will be destroyed in the near future (e.g. the world will end).

• Cotard delusions: These can be described as delusions in which a person believes they are already dead.  A person with Cotard delusions may deny that they exist and some of these individuals may simultaneously experience delusions of immortality