The presence of delusions is the most obvious sign of delusional disorder, which vary based on the type.
Another characteristic of this condition is that the person often lacks self-awareness that their delusions are problematic. They’re unable to accept that their delusions are irrational or inaccurate, even if they recognize that other people would describe their delusions this way.
Anger and violent behavior may be present if someone is experiencing persecutory, jealous or erotomanic delusions.
People with delusional disorder may also develop anxiety and/or depression as a result of the delusions.
Early symptoms of delusional disorder may include:
As with many other psychotic disorders, researchers don’t yet know the exact cause of delusional disorder. Researchers are, however, looking at the role of various factors that may contribute to the development of the condition, including:
Advertisement
Healthcare providers — mainly mental health professionals — diagnose delusional disorder when a person has one or more delusions for one month or more that can’t be explained by any other condition. The person must also not have the characteristic symptoms of other psychotic disorders, such as schizophrenia.
If someone is experiencing signs and symptoms of delusional disorder, a healthcare provider will perform a complete medical history and physical examination. Although there aren’t any laboratory tests to diagnose delusional disorder, their healthcare provider might use various diagnostic tests — such as imaging tests, a urine drug screen and blood tests — to rule out any physical conditions, medications or substances that could be causing the symptoms.
If their healthcare provider finds no physical reason for the symptoms, a consultation with a psychiatrist or psychologist will likely be made. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. They’ll ask questions about the delusions and assess the person’s mental status.
The psychiatrist or psychologist may also interview family members and friends so they can provide further details about the person’s delusions and a timeline of the symptoms.
Advertisement
As other mental health conditions can cause delusions, mental health professionals carefully assess the person for other symptoms. Delusional disorder can be misdiagnosed as any of the following conditions:
Treatment for delusional disorder most often includes psychotherapy (talk therapy) and medication, but delusional disorder is highly resistant to treatment with medication alone.
People with delusional disorder often don’t seek treatment for the condition on their own because most people with delusional disorder don’t realize their delusions are problematic or incorrect. It’s more likely they’ll seek help due to other mental health conditions such as depression or anxiety.
People with severe symptoms or who are at risk of hurting themselves or others might need to be admitted to the hospital until the condition is stabilized.
Psychotherapy is a term for a variety of treatment techniques that aim to help people identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to the person and their family.
Through therapy, people with delusional disorder can learn to manage their symptoms, identify early warning signs of relapse and develop relapse prevention plans. Types of psychotherapy include:
The primary medications used to help treat delusional disorder are called antipsychotics (neuroleptics). Medications include the following:
Other medications that healthcare providers might prescribe to treat delusional disorder include anxiolytics and antidepressants. Anxiolytics might help if the person has a very high level of anxiety and/or problems sleeping. Antidepressants can help treat depression, which often occurs in people with delusional disorder.
The prognosis (outlook) for people with delusional disorder varies depending on a few factors, including:
Delusional disorder doesn’t usually significantly affect a person’s daily functioning, but the severity of the delusion may gradually get worse. Most people with delusional disorder can remain employed as long as their work doesn’t involve things related to their delusions.
The prognosis of delusional disorder is better if the person sticks to their treatment plan. Almost 50% of people have a full recovery, more than 20% of people report a decrease in symptoms and less than 20% of people report minimal to no change in symptoms.
Unfortunately, many people with this condition don’t seek help. It’s often difficult for people with mental health conditions to recognize they’re not well. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long condition.
If left untreated, delusional disorder might lead to:
There’s no known way to prevent delusional disorder. However, early diagnosis and treatment can help decrease the disruption to the person’s life, family and friendships.
If you know someone with delusional disorder, you can help by providing support and encouragement for them to seek help and treatment.
People with delusional disorder who feel pressured or repeatedly criticized by others will likely experience stress, which may worsen their symptoms. Because of this, a positive approach may be more helpful and effective.
The friends and family members of people with delusional disorder often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
It’s important to remember that delusional disorder is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help manage thoughts and behaviors.
Your mental well-being is just as important as your physical well-being. Cleveland Clinic’s mental health experts can help you live life to the fullest.

Last reviewed on 05/22/2022.
Learn more about the Health Library and our editorial process.