Delusional beliefs are common in schizophrenia. People with this condition may have false beliefs that are hard to explain. A delusion is a fixed false belief that does not change, even when other people show that the belief is wrong. For example, a delusion might be believing someone wants to harm you or plotting against you.
Or it could be a belief that you are someone famous or have some extraordinary power or ability. Similarly, somatic delusions are false beliefs that involve misinterpreting a sensation in a specific body part. These sensations are commonly interpreted as signs of disease or that the affected part of the body is worthless, useless, or decomposing.
Sensations such as these have been documented for years and recognized as quasi-medical conditions by psychologists and psychiatrists for their propensity to be interpreted subjectively and perceived as facts. This article will explain what somatic delusions are in detail and the associated symptoms.
What Are Somatic Delusions?
Somatic Delusions are false beliefs about one’s body, such as being convinced that a limb isn’t part of one’s body. Someone with somatic delusions may have tactile hallucinations, believing that bugs/ insects are ” crawling on” or “burrowing into’ their skin. They may also believe they have an unusual odor/ smell coming from their skin or a wound. Not all delusions are bizarre; some are pretty ordinary and relate to one’s own or other people’s behavior.
Examples of somatic delusions include:
- The belief that one’s organs have been replaced or removed
- The belief that one’s limbs have been removed or replaced
- The belief that one’s bones have been removed or replaced
- The belief that a regular body part has become diseased or cancerous
Types of Somatic Delusions
Somatic delusions can be characterized as either bizarre or non-bizarre. Bizarre forms of somatic delusions are not plausible and seem impossible to occur according to the laws of one’s culture. Non-bizarre forms of somatic delusions may be possible and often do not contradict the ordinary life course in one’s culture.
An example of a bizarre form of somatic delusion would be a person who believes that aliens have implanted a device in their brain that allows them to hear the thoughts of others around them. An example of a non-bizarre form of somatic delusion would be a person who believes that their weight has suddenly dropped from 80 pounds to 50 pounds, despite weighing themselves and confirming that this is not the case.
What Are the Causes of Somatic Delusions?
The causes of somatic delusions are not well understood, and different factors may contribute to the disorder’s development. A combination of biological, social, and psychological factors may be involved. Following are some possible causes of somatic delusions:
Injury to a specific part of the right hemisphere (the right frontal lobe) has been linked to delusional disorder and other psychotic symptoms like hallucinations.
An individual’s risk for somatic delusions increases if someone in their family also has them or another mental health disorder like schizophrenia. A person’s genetic susceptibility may also play a role in developing symptoms.
Stressful events like abuse or trauma may increase an individual’s risk of developing somatic delusions.
Dopamine is a neurotransmitter that carries signals from the substantia nigra (a region in the brain) to other parts of the brain. In people with somatic delusions, dopamine levels are higher than usual. Some researchers believe this overproduction of dopamine can cause hallucinations, delusions, and other psychotic symptoms. Other researchers do not support this theory.
Somatic delusions are challenging to diagnose because people who suffer from them may not experience any other symptoms of mental illness besides these false beliefs about their bodies. For a diagnosis of somatic delusion disorder to be made, other psychological conditions must be excluded first, such as depression or anxiety disorders which may mimic symptoms similar to those seen in people with this type of delusional disorder.
Related Read: What is thought broadcasting?
Symptoms of Somatic Delusions
Somatic delusion is a rare psychiatric disorder. Its symptoms include believing that one’s body contains foreign objects, parasites, or diseases. It’s also called monosymptomatic hypochondriacal psychosis. Symptoms of somatic delusion may consist of:
- Believing that one has contracted diseases like cancer or AIDS without having any medical evidence that this is true
- Feeling that there is something wrong with one part of the body without being able to identify what it is
- The belief that one has already contracted an illness even though there are no symptoms present yet
- Believing that one’s organs are malfunctioning when there is no medical evidence backing up these claims
- Constant worry about getting sick and contracting diseases which may lead to panic attacks and extreme stress levels
Diagnosis of Somatic Delusions
A diagnosis of somatic delusion will likely be given when a person’s false beliefs about their physical health are severe and persistent. This means that the person has been acting on these beliefs for an extended period, and they are not just a passing thought.
The person may have had this condition for years, believing they have a severe illness or other medical condition.
They may have seen multiple doctors and specialists find out what is wrong with them and receive treatment. They may be undergoing medical testing, which is usually unnecessary as the cause of their symptoms is not a medical one. This can also lead to further distress for the person who believes these tests confirm their health concerns.
To diagnose somatic delusion with psychotic features, the following criteria must be met:
- Preoccupation with a physical defect or condition.
- Lack of insight into their condition, as evidenced by their belief that the problem is real but caused by something other than a mental illness (e.g., it is the result of an injury or event, caused by a chemical imbalance or allergy, etc.).
- The delusion causes clinically significant distress or impairment in social and occupational functioning, as evidenced by recurring episodes where they have taken action to remove the defect/condition from themselves (e.g., self-surgery).
- The symptoms are not better explained by another mental disorder such as body dysmorphic disorder, hypochondriasis, or delusional disorder; however, they can co-occur with these conditions if they are severe enough to warrant their diagnosis (i.e., all three conditions must be present).
A doctor will diagnose somatic delusion if there is no evidence or confirmation that an underlying health condition causes the person’s symptoms. In most cases, it will be apparent to the doctor that this is true and that nothing is physically wrong with the person.
Somatic Delusions vs. Hypochondriasis
Somatic delusions and hypochondriasis are often confused because they involve a preoccupation with health issues. However, there are several key differences between the two conditions.
With somatic delusions, a person believes something is wrong with their body, such as an illness or defect. They may also believe their body is somehow different from other people’s. These beliefs are not based on reality. People with somatic delusions may hear voices telling them something is wrong with their bodies. However, the delusions do not interfere with the person’s daily life.
Hypochondriasis is more than an obsession with health issues. Hypochondriasis involves a strong belief that you have a severe illness or defect even though it has not been diagnosed by a doctor or cannot be explained by medical science. This condition can lead to anxiety and depression and interfere with daily life.
It usually develops when you begin to notice a change in your body or experience symptoms of an illness, but you aren’t sure what is causing it. You begin to research possible causes for symptoms online or in books and become convinced that you must have some serious medical condition.
Treatment of Somatic Delusions
Treatment for somatic delusions is divided into pharmacological and non-pharmacological approaches. The mainstay of treatment is antipsychotic medications, which are effective in most patients.
Non-pharmacological treatments include psychotherapy, cognitive-behavioral therapy, and family therapy.
- Psychotherapy is a critical component of treatment for somatic delusions. Cognitive-behavioral therapy helps change delusional beliefs and can help the individual learn ways to cope with the distress caused by the delusion. In addition, psychoeducation about the nature of delusions can help someone experiencing them recognize them as a symptom of an underlying mental illness.
- Cognitive-behavioral therapy (CBT) alters patients’ thought processes by questioning their beliefs and looking at alternative explanations for events.
- The goal of family therapy aims to identify how the delusion has affected the patient’s family and help them adjust to the situation. Family members can be coached to respond in ways that reinforce the idea that delusional beliefs are not fundamental.
Although very rare, somatic delusions are an intriguing example of how our neurobiology affects our thought processes. By understanding how they work, we know how the brain processes information, not just the visual cues we take daily. This is a pretty fascinating branch of psychology that’s worth checking out.
The proper treatment of somatic delusions patients requires the assistance of both psychiatrist and a clinical psychologist. With careful attention and appropriate treatment, individuals with the deluded disorder can be symptom-free and lead healthy lives.
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- Slattery, H., & Nance, M. (2015). Treatment-resistant somatic delusions in bipolar disorder. BMJ Case Reports. https://doi.org/10.1136/bcr-2014-208375
- Joseph, S. M., & Siddiqui, W. (2021). Delusional Disorder. StatPearls [Internet]