The Conceptualization of Delusions and its Implication for Understanding and Treatment

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The Conceptualization of Delusions and its
Implication for Understanding and Treatment

• Stein Opjordsmoen
• Department of Psychiatrhy
• Ullevål University Hospital
• University of Oslo, Norway
• ---------------------
• Section of Clinical Psychopathology
• WPA

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• Multidimensional models have higher
• predictive value than categorical diagnoses
• (Peralta Cuesta, 2003)

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Conclusions

• Delusions best conceptualized as multidimensional
  
• Secondary to basic abnormality
• Rating scales with predictive power
• Defining homogeneous patient groups for studying
  the development of delusional beliefs and for
  specific treatments

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Delusions

• Unspecific in diagnostic terms
• Dimension vs category
• Non-clinical vs clinical

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Delusions

• A psychodynamic approach
• Escape from anxiety through denial and projection
• Comforting beliefs support the personality

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Delusion in DSM- IV

• A categorical approach (present or not) even
  though it is mentioned that delusional conviction
  occurs on a continuum
• Bizarre if they are clearly implausible and not
  understandable and do not derive from ordinary
  life experiences

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Delusions and nosology

• Delusional disorder (paranoia)
• Delusions understandable
• Patients arguing evidence
• Schizophrenia
• Delusions often bizarre(impossible content)
• Evidence not needed