If there is a history of aggression with adverse action, then hospitalization should be considered. Impulse control: It is important to evaluate for suicidal or homicidal ideations and plans. Ĭognition: Memory and cognition are usually intact, and patients are oriented unless there is a specific delusion about person, place, or time. Bizarre delusions more likely correlate with schizophrenia. Some patients are verbose and circumstantial when describing their delusions. It is essential to check the patient's belief before concluding it to be a delusion. The delusions are not bizarre and are clear as well as systematic for example a cheating spouse, persecutory delusions. Thought: This is the primary abnormality in delusional disorder. Auditory hallucinations may be present in some. Perceptions: Usually no abnormal perceptions are present. Mood: Mood is usually congruent with the delusion, for example, a grandiose patient may be euphoric, or a paranoid patient may be anxious. Patients seek an ally in the clinician, but it is important not to accept the delusion as it eventually results in confusing the patient’s reality and leads to distrust. It may seem odd, suspicious, can be litigious. General description: Patients are usually well-nourished, appropriately groomed.
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