What You Should Know About Delusions

  • Delusions are less common in PD compared to visual hallucinations. They affect approximately 8% of patients. However, delusions tend to be more complicated and present a greater risk for behavioral disturbances and safety concerns.
  • Delusions generally represent a more obvious deterioration or decline in one’s condition. 
  • Delusions are typically more difficult to treat than visual hallucinations.
  • Delusions are not only associated with medication side effects, but dementia as well. As a result, delusional patients are often confused and extremely difficult to manage. In these cases, many caregivers require outside assistance from family members, neighbors and/or home health care agencies.
  • Delusions can begin as generalized confusion at night. Over time, this confusion can develop into clear delusions and behavioral disturbances during the day.
  • All forms of delusions can be seen with PD although delusions of jealousy and persecution are most widely reported.
  •  Delusions of persecution (i.e.; paranoia) typically represent a greater challenge for treatment and general care by family members and loved ones.
  • Patients are often suspicious, argumentative, defiant and sometimes aggressive. This can pose a serious safety risk not only to the patient but family members and caregivers as well.
  • Paranoia can also lead to medication noncompliance, in which the patient refuses to take his/her pills because they are “poisoned” or “deadly”.

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Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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