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Identifying Delusional Disorder In Teens

depressed teenager

Previously referred to as paranoid disorder, delusional disorder is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a serious mental illness. A person being unable to distinguish between what is real from what is imagined characterizes this psychotic disorder. The primary feature of this disorder is the presence of delusions. Delusions, as defined in an article published by the Industrial Psychiatry Journal, are “false beliefs based on incorrect inference about external reality that persist despite the evidence to the contrary.” A young person with delusional disorder could become so preoccupied with their delusions that they result in notable disruption of their daily lives. While research indicates that delusion disorder most commonly presents in people between the ages of thirty-four to forty-five, it does not wholly preclude it from manifesting in teenagers. 

Types Of Delusional Disorder

There are several distinct subtypes of delusional disorder, which are based on the main theme of the delusion. These include:

  • Erotomanic Type: the person believes that someone is in love with them, and will behave accordingly, which can lead to stalking behaviors.
  • Grandiose Type: the person has an over-inflated sense of self, worth, power, and/ or knowledge. This can manifest as a belief that they have some exceptional (but unrecognized) talent and/ or insight and/ or have made some important discovery.
  • Jealous Type: the person believes that their significant other (i.e. spouse or sexual partner) is unfaithful.
  • Persecutory Type: the person believes that they are being conspired against, cheated, spied on, poisoned or drugged, followed, maliciously maligned, harassed or obstructed in the pursuit of long-term goals. This could lead the person to make repeated complaints to legal authorities.
  • Somatic Type: the person believes they have a physical deficit and/ or medical problem.

There is also a category for the mixed type in which a person experiences two or more of the delusions listed above.

Signs And Symptoms

Every teen is different and will likely present with a unique set of signs and symptoms associated to delusional disorder. Unlike other psychotic disorders, people with delusional disorder may not appear obviously bizarre, strange or odd during times of active illness. The Child Mind Institute provide the following examples of warning signs and symptoms that could be indicative of adolescent psychosis, including delusional disorder:

  • Lack of personal hygiene
  • Withdrawing from friends and family
  • Changes in sleeping and/ or eating patterns
  • Loss of usual interest in activities or of motivation and energy
  • Difficulty organizing thoughts and/ or speech
  • Development of unusual ideas and/ or behaviors
  • Change in personality 
  • Feeling like things are unreal
  • Feelings of grandiosity

The signs and symptoms that may be exhibited by a young person with delusional disorder will be distinct to the individual and will often vary from mild to severe. It is of utmost importance to obtain an accurate diagnosis from a qualified mental health professional, as the diagnosis will greatly inform one’s subsequent treatment plan. 

For Information and Support 

Seeking help is never easy, but you are not alone! If you or someone you know is in need of mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person for the long term. The earlier you seek support, the sooner you and your loved ones can return to happy, healthy and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769. You can also contact us via email at or through our contact form.

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