Teen Delusional Psychotic Disorder: An Illness of Illusions

It’s a disorder that’s strictly based on fantasy. Although it’s not a very common psychological illness, if it develops, its age of onset is typically late adolescence. Teens that suffer from this illness have a delusion (a false, fixed belief) involving real-life situations that could be true, such as being followed, being conspired against, or having a disease. To be diagnosed with teen delusional psychotic disorder, teens need to experience delusions for at least one month.


Delusions can be shaped by paranoia, such as “The FBI is after my family”, and they are typically held with conviction despite evidence that disproves the belief.  The essential illness of teen delusional psychotic disorder, as one recent article in The Guardian points out, is that it’s not so much what you believe, but more how you believe.


“In other words, simply believing something strange or unusual should not be considered a problem but having “stuck” beliefs that are completely impervious to reality suggests something is mentally awry.”


Think about it. Many teens and adults believe in something that might have evidence to disprove it. People believe in a higher being, in the fact that their spouse is cheating on them, in the return of Elvis, and in aliens visiting the Earth. Really, all it takes is a step away from the majority and a belief could suddenly be labeled a delusion.


Yet, the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized text used by clinicians across North America, takes all of this into account. It uses statistical analysis to determine abnormal behavior, or in this case, abnormal belief. A belief could be considered abnormal if it falls outside of a particular statistical range. For instance, if most people in the world can run a mile in 10 minutes, then that could be considered the normal range for the running speed of a human being. However, if someone can run a mile in 5 minutes or on the other end of the spectrum, let’s say 20 minutes, both the quick speed and the longer speed are considered to be statistically abnormal. When applied to mental health, someone who exhibits behavior that most of the population does not might be looked at as having a mental disorder.


However, being statistically abnormal does not immediately equate to having a disorder. For example, if an individual’s IQ is incredibly high, although it would be considered statistically abnormal, there’s no problem with being very smart! For this reason, other factors need to be considered, such as the cultural context, or if a delusion is causing harm. In this case, if a teen is participating in self-injury because he believes that aliens embedded a microchip in his skin, then psychological treatment might be in order. Furthermore, if a delusion causes significant distress, if it makes a teen feel depressed, anxious, fearful, or suicidal, then that would also warrant treatment.


Up until the recent edition of the DSM, delusions were divided into bizarre and non-bizarre. Bizarre delusions are those that are implausible, such as believing that a stranger removed your organs and replaced them with different ones without leaving any scars or wounds. Non-bizarre delusions are those that are probable, such as believing that someone close to you is going to die soon.  However, the latest version of the DSM removed non-bizarre delusions from the list of criteria for teen delusional psychotic disorder.


Clearly this is an intriguing disorder. However, if there is distress, harm, or danger that comes from it, a teen should be treated appropriately. He or she should see a psychologist or therapist, and if medication is needed, then perhaps a visit to a psychiatrist as well.


In a way, we might all have delusions, but as long as they don’t cause harm or stifle one’s life, then it’s fine if those delusions continue to exist.




Grohol, J. DSM-5 Changes: Schizophrenia & Psychotic Disorders. PsychCentral. Retrieved on June 11, 2014 from: http://pro.psychcentral.com/dsm-5-changes-schizophrenia-psychotic-disorders/004336.html

Bell, V. (August 3, 2013). You needn’t be wrong to be called delusional. The Guardian. Retrieved on June 11, 2014 from: http://www.theguardian.com/science/2013/aug/04/truly-madly-deeply-delusional