Talk:Delusion
From Academic Kids
This is a very well-done and fascinating article. --Daniel C. Boyer 20:38 24 Jul 2003 (UTC)
- Thanks! Vaughan
A false belief?
Firstly, well done. However, I am somewhat unhappy with one aspect of this article. For me it is the quality of the way the belief is held that is paramount. The belief does not have to be false. This is discussed in the article but I cannot see an acceptance in the article that a delusional belief may be true from the outset and yet still delusional. Let me give an example to clarify what I mean. A man with delusional jealousy about his wife presents and describes his concerns that his wife is unfaithful. He has the classic features. He presents clearly psychotic reasoning for his justifications, e.g. stains on her underwear are proof, her occasional looks outside the window are to see if her lover is there. You interview the wife and find that she had a brief affair a year before the onset of the husband's condition but there is no way that he could know about this. True his belief is of an ongoing affair and you could say that therefore his belief is false, but let's extend it and consider the case where the wife IS having an affair. The husband though is clearly psychotic in the way that he holds the belief. Now, one way to test this is to say it is the fixity of the belief but I do take the points in the article on this subject. I am afraid though in practice that this is probably the main deciding factor for me and many other psychiatrists I know. But how to express this in an article? --CloudSurfer 07:07, 16 Sep 2004 (UTC)
- Since writing the above I have had a look at one of the references given (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2225797&dopt=Abstract) in the article. I do not have access to the full article but it would appear from the abstract that it is dealing with the issue above. --CloudSurfer 05:24, 20 Sep 2004 (UTC)
- Hi there CloudSurfer,
- The initial sentence describes delusions as false beliefs as this is the everyday definition of a delusion. It then goes on to discuss the psychiatric definition which although currently does include the criterion of a delusional belief being false (as per the current DSM definition), it also requires that the belief be held in a certain way (again as outlined in the article).
- In terms of your point about delusional jealousy, I think the following paragraph covers this quite well:
- In other situations the delusion may turn out to be true belief. For example, delusional jealousy, where a person believes that their partner is being unfaithful (and may even follow then into the bathroom believing them to be seeing their lover even during the briefest of partings) may result in the faithful partner being driven to infidelity by the constant and unreasonable strain put on them by their delusional spouse. In this case the delusion does not cease to be a delusion, because the content later turns out to be true.
- However, I agree it could be clearer in explaining a belief may be true from the the start and still be diagnosed as delusional. However, as the diagnostic criteria for a delusion are at best, confused, and at worst, incoherent, meaning there is no adequate final definition (as the Spitzer article makes clear).
- - Vaughan 08:22, 20 Sep 2004 (UTC)
