Types of Delusions in Psychopathology

Types of Delusions

• Persecutory/paranoid delusions: client believes others are planning to harm them or spy on them
• Grandiose delusions: client claims association with famous people or believes they are capable of great feats
• Religious delusions: center around the second coming of Christ or another significant religious figure
• Somatic delusions: vague and unrealistic beliefs about health or bodily functions
• Sexual delusions: client believes their sexual behavior is known to others
• Nihilistic delusions: client believes their organs aren't functioning or are rotting away
• Referential delusions: client believes TV broadcasts, music, or newspaper articles have special meaning for them

Types of Hallucinations

• Auditory hallucinations: hearing voices, including command hallucinations that demand the client take action
• Visual hallucinations: seeing things that are not there
• Olfactory hallucinations: smelling things that are not there
• Tactile hallucinations: feeling sensations on the skin that are not there
• Gustatory hallucinations: tasting things that are not there
• Cenesthetichallucinations: feeling bodily functions that are usually undetectable

Long-Term Course of Psychosis

• Two patterns: ongoing psychosis with no full recovery, or episodes of psychotic symptoms with periods of recovery in between
• Intensity of psychosis tends to diminish with age
• Many clients with long-term impairment regain some social and occupational functioning, but few lead fully independent lives

Schizophrenia Spectrum and Other Psychotic Disorders

• Schizotypal personality disorder
• Delusional disorder
• Brief psychotic disorder
• Schizophreniform disorder
• Schizophrenia spectrum
• Schizoaffective disorder
• Substance/drug-induced psychotic disorder
• Psychotic disorder due to a medical condition
• Catatonia
• Other specified schizophrenia spectrum and other psychotic disorder
• Unspecified schizophrenia spectrum and other psychotic disorder

Schizoaffective Disorder

• Diagnosed when client exhibits psychotic and mood symptoms
• Can occur simultaneously or alternate between psychotic and mood disorder symptoms
• Treatment targets both psychotic and mood symptoms

Related Disorders

• Schizoaffective disorder
• Schizophreniform disorder: acute, reactive psychosis for less than 6 months
• Catatonia: marked psychomotor disturbance, excessive motor activity or immobility
• Delusional disorder: non-bizarre delusions with no marked impairment of psychosocial functioning

Immunovirologic Factors

• Theories suggest exposure to viruses or immune response to viruses could alter brain physiology in people with schizophrenia
• Cytokines may play a role in the development of major psychiatric disorders like schizophrenia
• Infections during pregnancy may contribute to the development of schizophrenia

Psychiatric Treatment of Schizophrenia

• Comprehensive treatment plan including pharmacotherapy, social support, social/life skills training, self-help groups, and family therapy
• Gaining life skills, occupational training, and family education can be helpful

Side Effects of Antipsychotic Medications

• Tardive dyskinesia: abnormal, involuntary movements
• Neuroleptic malignant syndrome (NMS): serious and potentially fatal condition characterized by muscle rigidity, high fever, and leukocytosis
• Agranulocytosis: failure of bone marrow to produce adequate white blood cells, potentially fatal side effect of clozapine

Nursing Care for Schizophrenic Patients

• Requires compassion and understanding
• Common nursing diagnoses include self-care deficit, sensory perception disturbed, social isolation, thought processes disturbed, and risk for violence
• Nursing interventions focus on promoting safety, establishing a therapeutic relationship, and promoting personal care and dignity