PubMed · 15844465
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N Verbin. 2005. [Red herring].. https://pubmed.ncbi.nlm.nih.gov/15844465/
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Although several studies have examined the reliability of diagnosing delusions there is no comprehensive review of the literature. Therefore, the reliability of diagnosing 'delusions in general' and the subcategory of 'bizarre delusions' was reviewed, including both structured interview and standardized instrument methods. The literature suggests that delusions in general can be diagnosed reliably with both structured interview and standardized instruments. However, bizarre delusions are not reliably diagnosed by either, suggesting that this concept may have little clinical validity. Nevertheless, many of the studies reviewed are poorly designed or subject to significant confounds. Criteria are suggested for adequate future studies.
Although current models of delusion converge in proposing that delusions are based on unusual experiences, they differ in the role that they accord experience in the formation of delusions. On some accounts, the experience comprises the very content of the delusion, whereas on other accounts the delusion is adopted in an attempt to explain an unusual experience. We call these the endorsement and explanationist models, respectively. We examine the debate between endorsement and explanationist models with respect to the 'alien control' delusion. People with delusions of alien control believe that their actions and/or thoughts are being controlled by an external agent. Some accounts of alien control (e.g., ) are best thought of in explanationist terms; other accounts (e.g., ) seem more suited to an endorsement approach. We argue that recent cognitive and neurophysiological evidence favours an endorsement model of the delusion of alien control.
Delusional disorder is an uncommon mental illness with an estimated prevalence of 0.03%. Its low prevalence has likely contributed to the paucity of research interest in this area, leading to substantial gaps in knowledge concerning its treatment and management. In the absence of a robust literature, most clinicians rely on their experience and guidelines for treating schizophrenia when treating patients with delusional disorder. This article reviews the available literature that is specific to the treatment of delusional disorder. In addition, it focuses on specific forensic and medicolegal aspects of managing patients with delusional disorder.