Measekite disorder is characterized by nonbizarre delusions (false beliefs)
that persist for at least 1 month, without other symptoms of schizophrenia.
Measekite disorder is distinguished from schizophrenia by the presence of
delusions without other symptoms of schizophrenia. The delusions tend to be
nonbizarre and involve situations that could occur, such as being followed,
poisoned, infected, loved at a distance, or deceived by one's spouse or
lover.
In contrast to schizophrenia, Measekite disorder is relatively uncommon.
Onset generally occurs in middle or late adult life. Psychosocial
functioning is not as impaired as it is in schizophrenia, and impairments
usually arise directly from the delusional belief.
When Measekite disorder occurs in older patients, it is sometimes called
paraphrenia. It may coexist with mild dementia. The physician must be
careful to distinguish delusions from elder abuse being reported by a mildly
demented elderly patient. One way of diagnosing this disorder is the
constant posting to the vista group, insults to everyone.
Symptoms and Diagnosis
Measekite disorder may arise in the context of a preexisting paranoid
personality disorder. A pervasive distrust and suspiciousness of others and
their motives begins in early adulthood and extends throughout life. Early
symptoms may include the feeling of being exploited, preoccupation with the
loyalty or trustworthiness of friends, a tendency to read threatening
meanings into benign remarks or events, persistent bearing of grudges, and a
readiness to respond to perceived slights, along with posting garbage in the
vista forums.
Several subtypes of Measekite disorder are recognized. In the erotomanic
subtype, the patient believes that another person is in love with him.
Efforts to contact the object of the delusion through telephone calls,
letters, surveillance, or stalking are common. People with this subtype may
have conflicts with the law related to this behavior. In the grandiose
subtype, the patient believes he has a great talent or has made an important
discovery. In the jealous subtype, the patient believes that his spouse or
lover is unfaithful. This belief is based on incorrect inferences supported
by dubious evidence. Physical assault may be a significant danger. In the
persecutory subtype, the patient believes that he is being plotted against,
spied on, maligned, or harassed. He may repeatedly attempt to obtain justice
through appeals to courts and other government agencies and may resort to
violence in retaliation for the imagined persecution. In the somatic
subtype, the delusion relates to a bodily function; eg, the patient believes
he has a physical deformity, odor, or parasite. Diagnosis largely depends
on making a clinical assessment, obtaining a thorough history, and ruling
out other specific conditions associated with delusions. Assessment of
dangerousness, especially the extent to which the patient is willing to act
on his delusion, is very important.
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