Introduction
Delusion of grandeur is one of the types of delusional disorder occurring with a wide range of other psychiatric diseases. This disorder is often known as grandiose delusions or expansive delusions. There is no significant gender prevalence of grandiose delusion. However, researchers identified that about 10 % of healthy people encounter grandiose delusion at some event in their complete existence. In addition, studies have found that this disorder occurs more frequently, with bipolar disorder 59 %, schizophrenia 49 %, substance misuse disorder 30 %, and depression 21 %.
What Is Delusional Disorder?
Delusion is a state of fixed false belief in which a person abides in things that are untrue or contrary to reality. In simpler words, it is the art of misconception or misperception resulting from incorrect reasoning. Delusional disorder is a mental or psychotic disorder of experiencing one or more delusions that typically impair judgment. People with the disorder could not differentiate between the imaginary and reality. On the other hand, people could socialize normally and be as highly functional as others. And they do not behave strangely or weirdly except for the theme of delusions. Delusional disorders can be bizarre or non-bizarre.
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A bizarre delusion is a belief in circumstances that can never happen in reality. For example, one can fly along with birds eventually.
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Non-bizarre delusion is a belief in situations that can ever happen to him. An example includes Being harmed by a lion in the forest.
How Are Delusional Disorders Classified?
The International Classification of Diseases classifies delusional disorders as mental and behavioral disorders. The Diagnostics and Statistical Manual of Mental Disorders summarizes the following seven types of delusional disorders.
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Erotomanic.
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Grandiose.
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Jealous.
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Persecutory or paranoid.
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Somatic.
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Mixed.
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Guilt.
What Is Delusion of Grandeur?
Delusion of grandeur is a mental illness characterized as a firm, fallacious belief in which the person highly exaggerates or overinflates that he is powerful, vogue, and hyper-intelligent, among others. They emphasize themselves as a superman, enchanter, or spell-caster. The delusions can be bizarre or non-bizarre. Delusion of grandeur is also known as Grandiose delusion or expansive delusion.
How Do Grandiose Delusions Occur?
Though the precise cause of grandiose delusion is still unknown, it has two alternate reasons: delusion occurs as a defense against depression and ceaseless emotions.
In addition, the following are the risk factors for the delusion of grandeur.
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Hereditary mental illness.
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Modification in the brain's neurotransmitter function by an imbalance in chemical substances such as dopamine and acetylcholine.
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Stress.
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Solitariness.
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Drug abuse.
What Are the Types of Grandiose Delusion?
People with grandiose delusions experience many delusions on different themes. Hence, they are classified according to their pieces as follows.
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A belief that one is exceptionally fierce.
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Belief in immortality.
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Conviction of being magical, such as reading others' minds.
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An intense belief that one is a national leader or most popular among others.
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One’s unique cultural belief can also result in delusion.
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Exaggeration of being the most clever one.
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A belief that one could never get injured.
What Are the Symptoms of Grandiose Delusion?
Addressing the signs and symptoms of people with grandiose delusion is challenging, as they have anomalous fantasy beliefs that their theme is actual and don't act oddly. They make sense of unusual or different events.
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Exaggerated belief in self-worth, power, knowledge, and identity.
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Other uncommon symptoms include stress, mood swings, hallucinations, and distractibility.
Hallucination is the perception of sensations that aren't present. Hallucination may be visual, auditory, or sensory. For example, one can hear or see the fairies.
How to Identify the Grandiose Delusion?
Though there is no evident tool to confirm grandiose delusion, the doctor will take a detailed medical history and rule out the history of delusions and mania that lasted a month or more.
The following are the common assessments.
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MacArthur-Maudsley's Assessment of Delusions Schedule is used to assess the delusion disorder.
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Mental Status Examination and Medical history with an underlying condition such as bipolar disorder and schizophrenia.
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Knowing any history of delusions or bipolar disorder, as they are recurrent.
What Is the Treatment for Grandiose Delusion?
People with grandiose delusions do not seek medical care independently because of their grandiose misinterpretation of the situation. However, research has proved pharmacotherapy and cognitive behavioral psychotherapy are efficacious treatments for grandiose delusions.
Pharmacological
Antipsychotic or neuroleptic drugs for any degree of depression and symptoms.
Neuroleptics can also be given with benzodiazepines, lithium, or anticonvulsants to relieve the symptoms.
Psychotherapy
- Cognitive behavioral intervention: To focus on the theme and clarify the neologisms.
- TALK therapy: taking extra time to talk when in distress. The therapists target the meaning of belief, mania, and fantasy elaboration.
When to Seek Medical Care?
The disorder is seldom debilitating and can hurt themselves in multiple domains, such as physical and emotional. In that case, one should seek medical care immediately. Grandiose delusion has the least susceptibility to suicidal thoughts and attempts.
Comorbidity
The existence of grandiose delusion with one or two of the following related disorders is its comorbidity.
- Bipolar Disorder
Bipolar disorder, also known as manic depression, is a mood illness ranging from a low depressive state to a high excitable manic state ( mania-very enthusiastic or violent). The severe manifestations of this mood disorder lead to inadequate sleep, visual or auditory hallucinations, and racing, disorganized refractory thoughts. Then this results in cognitive impairment and blends with grandiosity eventually.
- Schizophrenia
Schizophrenia is a chronic mental illness characterized by impairment in the perception of things about reality and behaving accordingly. The delusions result from explaining the scheme of hallucinations they are undergoing. Paranoid schizophrenia is the most common delusional disorder to occur with grandiose. About 50 % of people with schizophrenia encounter grandiose delusion.
- Obsessive-Compulsive Disorder
Patients with OCD may have fixed bizarre delusional beliefs and loss of insight.
- Dementia
Dementia is an impairment in memory that affects thinking and socio-behavioral functioning. Progression of this disease quite interferes with apparent thinking ability and thus enumerates grandeur delusions. Delusions may occur in the mid to late stage of Alzheimer's disease.
Narcissistic is a personality disorder in which the person has an inflated sense of self-importance. This disorder is featured by self-centered, arrogant thinking, lack of sympathy for others, and excessive need for admiration. Narcissists anticipate that they are superior to others and hence develop delusions.
Conclusion
Unless the person comes forward knowing their fantasies, it could be challenging to treat grandiose delusions. However, identifying those at higher risk and ensuring they receive appropriate pharmacological drugs along with psychological intervention can prevent the progression of the illness.
