From a nursing textbook:
Delusions: A false, unshakable belief which is out of keeping with the patients social and cultural background.
Primary delusions
- A new meaning arises not in connection with other psychopathological event and is not understandable.
- Delusional mood: has knowledge of something going on around him but do not know what it is.
- Delusional perception: attribution of new meaning to a normally perceived object.
- Delusional idea: delusion appears fully formed in the mind.
Secondary delusions
- A delusion which is understandable in terms of persons cultural background or emotional state.
Content of delusions
- Delusions of persecution
- Persons or groups.
- About to be killed or being tortured.
- Being robbed of property or knowledge.
- Of being poisoned or infected.
- Delusions of reference.
- Delusions of influence.
- Delusions of jealousy.
- Infidelity- seen in brain disease, alcohol addiction, affective psychoses and can be dangerous, may attempt murder.
- Delusions of love.
- Erotomania: may try to follow, contact or persuade.
- Grandiose delusions.
- Schizophrenia, drug dependence ,organic brain syndromes, mania (jocular and haughty).
- Regarding worth, talent, knowledge or power.
- Delusions of ill health
- Depressive illness, schizophrenia.
- Could be extended to cover persecutory delusions.
- Hypochondriacal delusions.
- Some physical defect, disorder or incurable diseases.
- Infestations, ugly or dysfunctional body parts
- May include spouse or children.
- Result of somatic hallucinations in schizophrenia.
- Delusions of guilt
- Unpardonable sin.
- Can give rise to persecutory delusions.
- Lead to suicide.
- Nihilistic delusions .
- Denies the existence of body, mind, loved ones or the whole world.
- Very agitated depression, delirium, schizophrenia.
- Delusions of poverty- Destitution is facing him and family.
- Delusional misidentification.
- Capgras syndrome.
- Religious delusions- Can be grandiose in nature.
- Delusions of control.
Treatment:
- Don’t play into the delusions, but don’t argue with the patient.
- Instead, be firm: “You know that isn’t true. Let’s stay focused on what is real.”
- Be calm, patient, acceptance, active listening. Don’t condemn the patient, but help them to come to the realization that what they are experiencing isn’t reality.
- Place delusion in a time frame and identify triggers.
- Identify all the components , triggers related to stress or anxiety.
- If related with anxiety, teach anxiety management skills.
- Develop symptom management program.
- Assess intensity frequency and duration
- Fleeting delusions can be worked out in a short time frame.
- Listen quietly until need to discuss.
- Identify emotional components.
- Observe for evidence of concrete thinking. Is patient and nurse using language in the same way?
- Observe speech for symptoms of a thought disorder.
- Maintain consistency.
Just going to leave this here while noting that it doesn’t say to buy into the delusion by using their preferred pronouns.