delusional disorder

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Every honest and complete psychiatric evaluation includes screening for delusions. A delusion is a strongly held belief that is totally without basis in the factual reality that we all use to live our daily lives. I have taken care of several people, institutionalized and not, who have had such beliefs.  Medications known as “antipsychotics” can be very effective on the hallucinations — the hearing voices and seeing things and such — that are the hallmark of a lack of mental “normalcy” as is generally expected and accepted in the community. The same medications may be less effective on these delusions, these beliefs.  Sometimes, in a particular kind of delusion, a kind that hits folks somewhere between 18 and 90 (average age 40) where there are no hallucinations, just beliefs.  They are less frequent.  They are also hard to treat, with antipsychotic medicines working maybe about half the time — in those who can actually be convinced to take them. Read more on Screening For Delusions…

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He was a new patient to a community clinic.  They warned me to be careful with this 48 year old, thinking he was “really crazy, schizophrenic or something.”  The social worker had tried to do the intake and told me he was confusing, “not your average bear.” Strangely enough, most of my female staff already had told me they were attracted to him; an unusual state of affairs.

I was struck first by his clothes and demeanor.  A little like Michael Douglas as Gordon Gekko.

This is not usually what new patients look like, schizophrenic or not, when they come in. No wonder the front desk staff already had a crush on him (“sigh!”).  We didn’t get men in designer suits in these parts. Read more on Otherwise, The Patient Was Normal…

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