The term delusional or paranoid encompasses a wide range of mental disorders characterized by suspiciousness, projection, excessive feelings of self-importance, and delusions. The delusional patient's cognitive abilities are usually intact, but thinking, affect, and behavior are all affected by delusions of grandeur (or persecution).
Delusions sometimes form part of the symptom picture in schizophrenia, particularly in younger patients, but delusions without schizophrenia are more common. The frequency of delusional disorders tends to increase with age, being exceeded only by dementia and depression in older adults. The delusions of older patients are often accompanied by a chronic hearing loss, which makes it difficult for them to understand what other people are saying and invites suspiciousness, and by cognitive disturbances, as in Alzheimer's disease. Older loners who have lived most of their lives in relative isolation from other people are more likely to be delusional than individuals with normal social interactions (Berger & Zarit, 1978).
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