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Delusions: what they are, types and differences with hallucinations

Delusions: what they are, types and differences with hallucinations

November 14, 2019

It is usual that at some time, and especially under high levels of stress, we are faced with the firm belief that someone is watching us, that someone is following us or that someone is talking about us even if this is not true.

However, when these ideas flood the person's mind and you are not able to see reality, we can talk about the known delusions . Throughout this article we will delve into the nature of this experience, as well as its causes, types and differences with other false beliefs.

  • Related article: "The 12 most curious and shocking types of delusions"

What are delusions?

Within the scope of psychopathology delirium is understood as a false belief or idea that the patient accepts with total conviction , even though the evidence or external evidence shows the opposite. Although it has not yet been possible to generate a fully accepted and satisfactory description of this concept, the previous description would be one of the most approximate.


Despite its pathological characteristics, delirium it is not considered a mental illness or disorder by itself , but rather it would be a symptom of a wide variety of psychological conditions such as bipolar disorder, schizophrenia, mania or psychotic depression.

During the course of delirium the mental state of the person experiences a great number of changes. These make the patient live feelings of confusion and behavior alterations .

Other manifestations or problems typical of delirious states are:

  • Abrupt changes between states of lucidity and unconsciousness.
  • Loss of contact with reality .
  • Alteration of attention and memory.
  • Emotional swings
  • Problems in the control of the musculature.
  • Alterations of the dream.

Diagnostic criteria

Although, as specified in the previous point, delusions do not constitute a clinical disorder, but are part of a larger pathological picture. Of course, they must meet a series of special and specific requirements in order that they can be considered as such.


Some authors and researchers have developed a series of defining constructs of delirium. These dimensions or constructs are given in the form of continuums that start from what is considered a normal belief, to a pathological one , and are key to differentiating delirium from other types of beliefs or misconceptions. These characteristics are what we will see below.

1. Fixed and unchangeable beliefs or ideas

The delirium must be maintained over time ; being little or nothing possible that this can be modified or corrected independently of the evidence that has against him.

2. Intense conviction

A delirium is a firmly held idea. That is to say, the person believes blindly in an idea or concrete event.

3. Lack of cultural supports

It is necessary to specify that the idea that the patient maintains it can not be shared by other people or cultural group . This means that for the belief to be considered irrational it can not be shared or accepted by the rest of the reference society.


4. Excess of concern

Unlike other types of false or irrational beliefs, in delusions the person presents a great concern or rumination of the delusional idea, which it implies a significant psychological wear since the patient thinks of her in an obsessive way.

5. Degree of likelihood

This last criterion refers to the degree of probability that exists that the idea can be real. This degree of plausibility may vary from one delirium to another. This means that although in some cases it is easy to detect the impossibility of the delusional idea, in others they may be totally plausible but false .

What causes do they have?

Delusions and delusions have as their origin a series of mental and psychological disorders that accompany and shape it. These psychological conditions are:

  • Paranoid disorders
  • Paranoid, schizoid and schizotypal personality disorders.
  • Schizophrenia .
  • Affective disorders such as psychotic depression and mania.

However, also they can be part of other alterations of organic origin derived from the consumption of drugs and alcohol in abuse, as well as detoxification processes and as a secondary reaction to certain drugs.

  • Related article: "Delirium tremens: a severe alcohol withdrawal syndrome"

What types of delusions are there?

Despite the large number of existing delusions, these can be categorized and classified according to their content. Below we will see some of the most frequent and known.

1. Paranoid delirium

In the case of paranoid ideas, the person is convinced that a person or group wants to cause some kind of harm , whether physical, psychological or social. This delirium can be realized in the idea that others want to kill him or that someone is trying to drive him crazy.

2. Delusion of persecution

People suffering from persecution delirium firmly claim that someone is persecuting them, or even that there is a conspiracy against them. This persecution can be either on the street, directly, or more veiled: patients may think they are entering their home, opening their mail or registering their mobile devices or computers.

3. Delirium of greatness

The content of this delirium is manifested by excessive self-assessment of skills and powers of the patient; which attributes special abilities as well as a great consideration of its own identity.

  • Maybe you're interested: "Megalomania and delusions of grandeur: playing at being God"

4. Reference delirium

As the name suggests, in the delirium of reference the patient believes that certain events, phrases or statements of other people have to do with his person or have a special significance that has to do with him.

It is common for these patients to think that both the media and other people are sending them all kinds of messages.

5. Somatic delirium

In this last case, the patient shows the conviction that you are sick or your body is getting sick . In the same way you may come to perceive a series of false changes or abnormalities in this. These are only a small sample of what is really a long list of delusions and delusions.

6. Other

Other well-known delusions are:

  • Control delirium.
  • Metacognitive delirium
  • Delirium of guilt or sin.
  • Celotypic delirium .
  • Delusion of false identification.
  • Erotomaniac delirium.

What is the difference between delirium and hallucination?

The fact of in many occasions come together and share certain characteristics makes delusions and hallucinations are frequently confused . However, once we know what delusions are, it is much easier to differentiate them.

Unlike delusions, hallucinations are an original product of the person's mind. That is, they do not really exist in reality or in the external world of this. In addition, just as delirium is an idea, hallucinations can be auditory, visual, tactile or even gustatory experiences. Therefore, the main difference between both concepts is that the hallucination is a totally original product and invented by the mind of the person, while the delirium would be a distortion of an external stimulus .

For example, in a delirium the person can perceive a real stimulus such as the radio; However, the mind distorts the message or interprets it as a kind of communication for him. While in the hallucination auditory stimulus would be completely invented by the mind, not being able to be perceived by anyone else.

Delirium would consist of a belief or misinterpretation of reality based on a fact, situation or real stimulus. However, both concepts have a common point. In this case it is that patients are fully convinced of the reality and truth of their ideas or beliefs.


Schizophrenia Overview | Clinical Presentation (November 2019).


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