What Are the Primary Manifestations of Delusions?

There are five types of delusion: erotic delusion, grandiose delusion, jealous delusion, persecutory delusion, and somatic delusion. Each type manifests differently.

1. Erotic delusion: The patient believes that they are in a romantic relationship with someone or that another person deeply loves them. This type is more common in women. The imagined lover is usually of a higher status, often unreachable, and may even be a phantom that does not exist in reality. The patient often believes that the other person fell in love with them first, but in reality, there is little or no actual contact between them.

2. Grandiose delusion: The patient delusionally believes that they possess supreme talent, insight, value, power, knowledge, identity, etc. Driven by this belief, the patient may deliberately change their lifestyle to cater to their delusion, becoming extravagant, arrogant, and obsessive.

3. Jealous delusion is a pathological mindset in which the patient believes that their spouse or lover is unfaithful. Instead of first taking steps to obtain evidence of infidelity, the patient may incorrectly infer and confirm the delusion based on trivial circumstantial evidence.

4. Persecutory delusion involves a firm belief that one is being persecuted, deceived, tracked, poisoned, slandered, or targeted by a conspiracy. The patient often becomes extremely cautious and defensive, magnifying minor insults and incorporating relevant individuals into their delusional world.

5. Somatic delusion occurs when the patient insists that they are ill and frequently seeks medical attention, despite treatment being ineffective. Common manifestations include beliefs that they emit an offensive odor from their skin, mouth, anus, or vagina; that parasites are drilling or crawling inside their body; that insects are crawling on their skin; that certain parts of their body are deformed or ugly beyond normal; or that certain organs have lost their function.