Differences between delusion, overvalued idea and obsessive idea

Within psychopathology, there are numerous phenomena related to thinking. Some examples of these are delusions, overvalued ideas and obsessive ideas. Surely these concepts sound familiar to you, but Do you really know what each of them consists of? Although they may seem similar concepts, they are not. Thus, today we will talk about the difference between delirium, overvalued idea and obsessive idea.

These have to do with their nature, theme or emotional involvement on the part of the subject, among others, and knowing them will allow us to make a good differential diagnosis. Furthermore, before knowing these differences, we will briefly explain what each of these concepts consists of.

Delusion, overvalued idea and obsessive idea: What are they?

Before knowing the differences between delusion, overvalued idea and obsessive idea, we are going to briefly define each of these concepts. As a fundamental characteristic to know, we will say that Delusions are disorders of the content of thought, typical of psychotic disorders such as, for example, schizophrenia. or delusional disorder. That is, they do not appear in the general (non-clinical) population.

Instead, Obsessive ideas can appear in people without any mental pathology or in people with an obsessive or paranoid personality disorder.

Finally, overrated ideas are also common in the general population (although they can also appear in certain disorders) and are characterized by the great emotional burden that the person gives them.

Delusions

The American Psychological Association (APA, 1988, 2013) defines delirium as ‘ an erroneous personal belief that is based on incorrect inferences from external realityheld firmly despite what others believe and in open opposition to obvious evidence or controversial evidence.’

Furthermore, these beliefs are not accepted by other people of the same cultural group (that is, it is not, for example, an article of religious faith). The main characteristics of delusions are the following:

Unchangeability, incorrigibility or fixity: maintenance of delirium over time. Intensity or conviction: degree of conviction shown by the person (usually absolute). Absence of cultural supports. Concern: the delusion or belief is important to the person (has emotional charge). Implausibility: refers to the extravagant quality of delirium, and the degree to which it deviates from reality.

Overrated ideas

For its part, the term overvalued idea was coined by Wernicke, a psychiatrist, in 1892. These are propositions that occur in the person under the influence of events in the outside world.; In these cases, judgment has a strong emotional influence that prevails over thought and subjugates human behavior.

So, Overrated ideas have an important emotional charge (and emotional involvement) by the subject, which makes them predominate over the rest of the ideas. Their formation is influenced by political and religious ideas held by the subject, as well as certain events experienced.

obsessive ideas

Finally, obsessive ideas (also called obsessive thoughts) are thoughts or images whose central characteristic is their persistence and intrusion uncontrolled in the mind of the subject. They tend to be absurd and crazy ideas and in turn cause discomfort, suffering or interference in the person who experiences them.

Another characteristic is that those who have them fight against them (to “get them out of their heads”), due to the degree of anguish they generate. We find three types: obsessive-compulsive ideas (they induce the person to carry out peculiar acts; the so-called compulsions typical of OCD), phobic obsessive ideas (intense fear of something, lacking foundation) and pure obsessive ideas (they are in the level of thought generating anxiety, but they do not drive the person to carry out compulsions).

Differences between delusion, overvalued idea and obsessive idea

It is important to make a good differential diagnosis of delusions, overvalued ideas and obsessive ideas.. We have seen what each of these concepts consists of. But what differences and similarities are there between each of them? We are going to classify them according to a series of parameters:

Emotional involvement/concern

Both delusions, overvalued ideas and obsessive ideas have the following common characteristic: they have a strong impact on the subject’s emotional sphere. That is, it is something that worries the subject, who becomes emotionally and intensely involved in his delusion or idea. On the other hand, delusions have a meaning for the subject, however, obsessive ideas do not.

Understandability

One of the differences between delirium, overvalued idea and obsessive idea is that only the last two are understandable from a psychological point of view, something that does not happen in the case of delusions.

Consensus validation

Both overvalued ideas and obsessive ideas can be validated consensually with other people.; that is, they can affirm that it is true. On the other hand, this does not happen with delusions, since consensual validation does not occur (these are ideas only followed or “believed” by the subject himself, that is, the rest of society does not share those ideas).

Social issue

This parameter refers to the content of the ideas; In the case of overrated and obsessive ideas, these are usually social-themed. On the other hand, in delusions it does not occur so frequently; That is, the content of the delirium varies much more.

Personal theme

Another difference between delusion, overvalued idea and obsessive idea is the one that refers to personal content; This criterion is only followed by delusions (which usually have a personal theme for the individual who suffers from them, for example a persecutory delusion). In the case of overrated ideas, the content is usually not personalbut in obsessive ideas yes.

Remission with treatment

Both delusions and obsessive ideas generally remit or weaken with appropriate intervention. On the other hand, this does not usually happen with overvalued ideas (they do not resolve with treatment).

Monothematic

In the case of delusions, these are sometimes monothematic (they focus on a single topic), although not always, and the same goes for obsessive ideas. On the other hand, in overrated ideas this is always the case (they are almost always monothematic).

Fight it

Of the three concepts, The only time a struggle on the part of the subject occurs is in obsessive ideas. (the person fights against these ideas because they generate anxiety or suffering). On the other hand, both in delusions and in overvalued ideas, this does not happen; That is, the subject does not fight against these ideas.

Degree of certainty

Finally, another difference between delusion, overvalued idea and obsessive idea has to do with the degree of certainty that the person grants it. Thus, in the case of delusions, the person grants them the nature of absolute certainties, treating them as if they were realities.

This is what is known as the intensity or conviction of the delirium (a characteristic of them), and refers to the degree of conviction that the person shows towards them. Instead, In overvalued and obsessive ideas, this degree of certainty or conviction is variable (and therefore, it is usually lower). That is, in these last two cases the subject does not “believe” these ideas as much and therefore in therapy they are usually easier to work with.

As we see, these three concepts of psychopathology differ from each other in different parameters. When a person comes for a consultation, it is not always easy to determine the nature of their symptoms, so a good clinical interview, along with other data collection techniques, will be essential to understand these symptoms well.

Similarly, Performing a good differential diagnosis between delirium, overvalued idea and obsessive idea will allow us to better understand the patient. and offer you personalized treatment adapted to your problem.

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