Delusion of reference: what it is, how it affects us and disorders that cause it

Psychotic disorders are mental problems that alter how we perceive reality. Schizophrenia and other disorders of this type can manifest delusions, very common symptoms in psychotic pictures.

Delusions of reference are a type of psychotic manifestation, although they can occur in other disorders beyond the spectrum of schizophrenia. Patients who suffer from it believe that what happens in the world is with them, that what others say and do is related to them.

In this article we are going to delve into the delusion of reference, what its characteristics are, possible causes and treatment.

• Related article: "The 9 types of thought and their characteristics"

What are delusions of reference?

No one perceives reality as it is. All of us have belief systems that make us interpret the world through a filter that distorts it. Our belief systems prevent us from being completely objective, making us victims of multiple distortions and cognitive biases that explain why two people are able to see different things from the same stimulus. This is not pathological, but part of the human condition.

However, there are some limits. Despite interpreting the world through a personal lens that changes everything, the normal thing is that he does not stray too far from reality itself. The opposite case is having a delusional perception of things. When we talk about delusions we refer to a series of beliefs that pathologically alter perception. Because they are not based on reality, delusions are not shared within the patient's culture and social group., which makes it stand out, and not for the better.

In delusion of reference or self-referential, the focus is the patient himself. The person who manifests this distortion of reality believes that external situations, such as the behavior of others, are related to him. He may think that people are sending him hidden messages through body language, that people whisper in his presence. There are cases of people who think that billboards, television commercials or daily news are made to send a message to you.

Generally delusions are a symptom of mental disorders belonging to the schizophrenia spectrum, although they can also occur in other disorders with or without psychotic symptoms. In the case of delusions of reference, this can worsen and become a disorder in itself, delusional disorder.

• You may be interested: "The 8 types of Psychotic Disorders"

Manifestations of delusion of reference

The delusion of reference shares with the rest of delusions the following manifestations:

• Delusional content hallucinations
• Affective state in line with the delusional theme
• Absence of judgment of psychological problem
• Various vital areas affected depending on the content of the delusion

Although delusions are considered pathological, they can occur as an isolated symptom. In other words, they do not necessarily have to be accompanied by a mental disorder in its extension, with which which may be absence of other psychotic symptoms or impairment in the psychosocial activity of the individual. However, if it gets worse, it could end up presenting a serious disorder such as schizophrenia or other psychotics.

In the specific case of delusion of reference, the manifestation that would differentiate it from the rest is, as we have commented, the delusional idea that everything that happens in the life of the subject has to do with it. In other words, the delusional theme of this problem is the erroneous personal attribution to the person himself, that everything that happens goes with him or her.

Like other types of delusions, if not detected early and treated early, its course is chronic. It begins with the suspicion that everything that happens around her has to do with him or her and, with the passage of time, a delusion is constituted with ideas such as that they are trying to communicate with the patient through television, radio or even products from the supermarket.

The delusion of reference has low prevalence. The data indicates that it would be found between 0.03 and 1% of the population, being more common in women than in men. As with other delusions, and this being a useful feature in the differential diagnosis with other disorders of the psychotic spectrum, its appearance is late It usually appears after 40 years.

• Related article: "Cognition: definition, main processes and functioning"

Causes of this delirium

There is no known clear cause that explains the appearance of delusions of reference. As with the rest of delusions and, also, of mental disorders in general, it is assumed that must be the result of the interaction between hereditary aspects and the environment in equal parts.

However, the fact that the exact cause is not known does not mean that there are no known risk factors for manifesting this delirium. Among such factors it is considered that they would be drug and psychoactive substance use, history of delusional episodes, and family history of mental disorders, especially if they are psychotic disorders or contain psychotic symptoms, such as the following:

• Schizophrenia
• Schizophreniform disorder
• Schizoaffective disorder
• delusional disorder
• brief psychotic disorder
• Shared psychotic disorder (Folie à deux)
• General Medical Condition Psychotic Disorder
• Substance Intoxication Psychotic Disorder
• Bipolar disorder
• unipolar depression
• Dementia

@image (id)

• You may be interested: "The 16 most common mental disorders"

An investigation into this psychological phenomenon

A study that draws attention regarding this delusion is the one carried out by the group of Mahesh Menon and colleagues in 2011. In their research it was concluded that the structures of the cortical midline, the subcortical regions, the amygdala and the corpus striatum are implicated in the appearance of self-referential delusion. In his work, it was found that people who present such delirium show greater activation in these brain areas.

In addition, these same authors found that patients with delirium of reference they did not show a pattern of differential activation when they received information about them and contrary information. In other words, his brain had problems differentiating the information that was directed at these patients from that which was not. This has served as a neurological explanation for the tendency of patients with this delusion to interpret the behaviors of others or everyday situations as something that goes with them.

• Related article: "Parts of the Human Brain (and Functions)"

Treatment

When the delusion of reference is a symptom of another disorder or caused by a general medical condition, the treatment is oriented towards intervening on the pathology that has caused it. That is, if, for example, the patient has delusions associated with schizophrenia, the main treatment will be focused on treating that disorder.

The main therapeutic route is pharmacological., specifically using antipsychotics. Added to it, psychological therapy is also used, being cognitive-behavioral type treatments those that have been shown to be the most effective for the therapeutic approach to delusions and other symptoms psychotic

In the specific case of delusion of reference, tools such as cognitive restructuring and confrontation, with the aim of increasing the rational judgment of the patient towards himself and try, also, to dismantle the beliefs that have based his particular idea delirious.