Delusional

Delusional refers to beliefs held with strong conviction despite clear evidence to the contrary and in many cases without regard to the person's cultural background. In psychiatry, a delusion is a fixed, false belief that is not shared by others in the person's culture and remains resistant to reason or contrary evidence.

Delusions are a central feature of several disorders, including delusional disorder, schizophrenia spectrum disorders, and mood disorders with psychotic features, but may occur in other conditions as well. They are distinguished from overvalued ideas, which are preoccupations that are less rigid, and from misinterpretations of real events.

Common content types include persecutory, grandiose, referential, erotomanic, nihilistic, and somatic delusions, as well as delusions of control or thought insertion. Content alone does not determine diagnosis; per DSM-5, a delusion must be fixed, not culturally sanctioned, and persistent.

Diagnosis and management: In delusional disorder, one or more delusions persist for at least one month with relatively intact functioning and without prominent hallucinations. Treatment typically involves antipsychotic medication and psychotherapy; addressing comorbid conditions and safety concerns is important. Cultural considerations are essential to avoid mislabeling culturally shared beliefs as delusions.