Chronic Delusions

* They have a common evolutionary potential typically no deficit, which contrasts with schizophrenic delusions

* They usually occur on a mature personality from 30 to 50 years

* Three chronic delusions: paranoid delusions; paranoid schizophrenia; paraphrenia

* Paranoid Delusions: These are the most systematized delusions where the interpretive mechanism is predominant delusional

* Enlarged me => = proselytism fanaticism; intolerance

* The paranoid is a colossus on clay country -> profound vulnerability of the hidden personality behind the aggressive and temperamental rigid shell

* Reference Idea: tendency to interpret accidental incidents and behaviors of others as direct relation with oneself (interpretative delirium)

Chronic Delusions
Paranoid delusions:

+ Premorbid personality: paranoid personality sthenic;Exception: sensitive personality Kretschmer (the subject is neither sthenic or confident). In delusions of interpretation, the premorbid personality is inconstant.

+ Décompensants factors: the event usually emotionally charged. In the delirium of interpretation, the delusional process appears most often endogenous.

+ Develop delusional: they are the most systematized of all chronic delusions. They are consistent with logical construction (paralogical); convincing (induced delirium). Membership in delirium is total. The paralogical thought is developed from real events (interpretation) or which originated in the subjectivity of the subject (intuition).

PERSONALITY:

– Mistrust

– Enlarged me

– Psychorigidité

– Falsehood judgment

– Lack of tenderness

DELUSIONS PASSION:

– Sector Development (delirium is expressed in a single domain)

– It begins with a sudden intuition and delirious delirium is enriched with delusional interpretations.

– There are 3 types of delusions of passion:

* Delusions of damage or claim (vexatious processive) -> intuitive mechanism and interpretative

* Delusions of jealousy (insidious and gradual onset); the subject is convinced of being cheated by his partner sex

* Erotomania: delirious illusion of being loved; goes through a stage of hope -> Despite -> grudge.

DELIRIUM INTERPRETATION:

– Described by Serious & Capgras

– The central mechanism is the interpretation; gradual onset

– Delirious themes are: prejudice, malice and sometimes megalomania.

– It develops delirium “network”; it does not grow at random; interpretation of any event that is attached to his delusional system.

– Conviction absolute delirium, unshakable

– Sometimes combination of intuition or illusions

– The hallucinatory phenomena are rare

– The natural course is shortness of delirium; sometimes punctuated by fecund moments with reactivation of delirium

DELIRIUM RELATIONSHIP SENSOR:

– Described by Kretschmer

– Interpretative mechanism; sensitive paranoid personality types

– Often develops after an event experienced as painful or humiliating

– Delirium said “reference”; the subject is convinced his entourage conspiring against him, is despised, mocked him …

– No aggressive response; it internalizes (asthenic) -> Depression

Paranoid schizophrenia:

* It usually occurs in middle-aged women (30 to 50)

* Sensitive or psychasthenic Personality: trend scruples; emotional inhibition; difficulty making a decision  painful introspection.

* The beginning is often brutal: acute delirious episode rich hallucinations made a mental automatism; cenesthetic painful sensation

* Status Period: The subject develops delirium more or less systematized which aims to “streamline” the perceived hallucinatory phenomena (of the course of thought disorders). The patient believes that it is under the control of an external force … (influence syndrome).

* The hallucinations are primarily psycho hearing

* The dominant theme is the persecution. The persecuted or depressed patient responds passively (the opposite of paranoid).

* Coping with the subject remains long preserved but the demented evolution is possible futures (progressive break with reality). The neuroleptic treatment can lead to complete remission or enkystement delirium.

Paraphrenia:

* If characterized by their rarity, their late start (35 to 45), their organization little systematized, the predominance of imaginative events with themes of grandeur and fantastic.

* The beginning is often gradual and slow; the subject develops emotional withdrawal

* The status phase is characterized by a rich and imaginative delirium fantastic

– Imaginative paraphrenia -> little hallucinatory; storytelling enriched through reading, discussion …; the themes are megalomania, parentage, and wealth.

– Fantastic paraphrenia consists of hallucinatory delirium and imaginative mechanism. Hallucinations are rich (hearing, mental automatism). The theme is spooky, cosmogony. Euphoria.

* A long-term and untreated, delirium in a spontaneous tendency to form cysts; sometimes shift towards a schizophrenic dissociation. Depression.