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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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My son, who finished highschool with good grades, began

Customer Question

My son, who finished highschool with good grades, began developing a suspicion of people, including friends and family members, while in his second year of college. The distrust grew over a short period of time from mild to more severe at times. This distrust was triggered by real events but with a distorted perception. In most cases, he feels that minor comments or gestures are directed at him in a negative way. For example, a cough by someone in the room may be perceived as a personal attack since he smokes cigarettes. In some cases he may perceive this as an attempt to mimick. As a result, he has moved towards social isolation since he feels uncomfortable around people and get angry easily. He does not have visual or auditory hallucinations. His delusions would be considered non-bizzare.
We are trying to understand if this is a delusional disorder or paranoid schizophrenia. There is no schizophrenia that runs in our family that we could find. He has now been suffering from this illness for almost 3 yrs. He takes 30 mg Abilify and 800mg seroquel. We would also like to know the most effective treatment for this type of illness.
Submitted: 7 years ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 7 years ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear parent,

Your son appears to be suffering from Delusional Disorder, Persecutory Type. This is the most common variety.

Delusional order is a lot less common than Schizophrenia, and usually does not lead to it. As you noted, correctly, the lack of hallucinations and the nonbizarre thinking lead diagnosis away from schizophrenia. HIs relatively late onset (age 19) is also typical of Delusional Disorder.

He has certainly been given a shopping list of pharmaceuticals, which is one approach that is used.

There may be other reasons for his delusional thinking. Let me mention them briefly:
  • Central nervous system disorders, including tumors and seizure disorders
  • Vascular disease
  • infectious diseases
  • Metabolic disorders
  • Endocrinopathies
  • Vitamin deficiencies
  • Medication reactions
  • Toxins
  • Drug use (pot, meth, coke, etc)
Somatic delusions seem more responsive to antipsychotic therapy than other types of delusions (regardless of whether this treatment was pimozide or other antipsychotics). However, this apparent difference may mostly result from the generally poor response rates for delusional disorder with persecutory delusions (50% improvement rates, with no reports of complete recovery).

If he has not been thoroughly checked out medically, then do so as you may discover other factors. Genetics are also important, as this can be inherited.

If I have helped and shed some more light on your situation, please accept my answer so that I may continue the important work of helping others in need and pain.

Great blessings to you family.

Elliott Sewell, LPCC, NCC