A fixed fantasy — also known as a "dysfunctional schema" — is a belief or system of beliefs held by a single individual to be genuine, but that cannot be verified in reality. The term is typically applied to individuals suffering from some type of psychiatric dysregulation, most often a personality disorder.

The term is also used in the different context of psychoanalysis to distinguish between 'a normal transitory one and a fixed fantasy' with respect to the phantasised 'fulfilment in conscious or unconscious thought of the sexualised wish'.

The Truman Show delusion, informally known as Truman syndrome, is a type of delusion in which the person believes that their lives are staged reality shows, or that they are being watched on cameras. The term was coined in 2008 by brothers Joel Gold and Ian Gold, a psychiatrist and a neurophilosopher, respectively, after the film "The Truman Show".

The Truman Show delusion is not officially recognized nor listed in the "Diagnostic and Statistical Manual of the American Psychiatric Association".

Folie à deux (; ; French for "madness of two"), or shared psychosis, is a psychiatric syndrome in which symptoms of a delusional belief and sometimes hallucinations are transmitted from one individual to another. The same syndrome shared by more than two people may be called "folie à trois", "folie à quatre", "folie en famille" ("family madness"), or even "folie à plusieurs" ("madness of many").

Recent psychiatric classifications refer to the syndrome as shared psychotic disorder (DSM-IV – 297.3) and induced delusional disorder (F24) in the ICD-10, although the research literature largely uses the original name. This disorder is not in the current DSM (DSM-5). The disorder was first conceptualized in 19th-century French psychiatry by Charles Lasègue and Jean-Pierre Falret and is also known as Lasègue-Falret syndrome.

Erotomania is a type of delusional disorder where the affected person believes that another person is in love with him or her. This belief is usually applied to someone with higher status or a famous person, but can also be applied to a complete stranger. Erotomanic delusions often occur in patients with schizophrenia and other psychotic disorders, but can also occur during a manic episode in the context of bipolar I disorder. During an erotomanic delusion, the patient believes that a secret admirer is declaring his or her affection for the patient, often by special glances, signals, telepathy, or messages through the media. Usually the patient then returns the perceived affection by means of letters, phone calls, gifts, and visits to the unwitting recipient. Even though these advances are unexpected and often unwanted, any denial of affection by the object of this delusional love is dismissed by the patient as a ploy to conceal the forbidden love from the rest of the world.

Erotomania is also called de Clérambault's syndrome, after French psychiatrist Gaëtan Gatian de Clérambault (1872–1934), who published a comprehensive review paper on the subject ("Les Psychoses Passionnelles") in 1921. Erotomania should not be confused with obsessive love or obsession with unrequited love, neither of which involves delusion.

The core symptom of the disorder is that the sufferer holds an unshakable belief that another person is secretly in love with them. In some cases, the sufferer may believe several people at once are "secret admirers". The sufferer may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates his or her love by subtle methods such as body posture, arrangement of household objects, and other seemingly innocuous acts (or, if the person is a public figure, through clues in the media). Erotomanic delusions are typically found as the primary symptom of a delusional disorder or in the context of schizophrenia and may be treated with atypical antipsychotics.

This syndrome is most commonly diagnosed when the two or more individuals concerned live in proximity and may be socially or physically isolated and have little interaction with other people. Various sub-classifications of "folie à deux" have been proposed to describe how the delusional belief comes to be held by more than one person :

- Folie imposée is where a dominant person (known as the 'primary', 'inducer' or 'principal') initially forms a delusional belief during a psychotic episode and imposes it on another person or persons (known as the 'secondary', 'acceptor' or 'associate') with the assumption that the secondary person might not have become deluded if left to his or her own devices. If the parties are admitted to hospital separately, then the delusions in the person with the induced beliefs usually resolve without the need of medication.

- Folie simultanée describes either the situation where two people considered to suffer independently from psychosis influence the content of each other's delusions so they become identical or strikingly similar, or one in which two people "morbidly predisposed" to delusional psychosis mutually trigger symptoms in each other.

Folie à deux and its more populous cousins are in many ways a psychiatric curiosity. The current Diagnostic and Statistical Manual of Mental Disorders states that a person cannot be diagnosed as being delusional if the belief in question is one "ordinarily accepted by other members of the person's culture or subculture" (see entry for delusion). It is not clear at what point a belief considered to be delusional escapes from the "folie à..." diagnostic category and becomes legitimate because of the number of people holding it. When a large number of people may come to believe obviously false and potentially distressing things based purely on hearsay, these beliefs are not considered to be clinical delusions by the psychiatric profession and are labelled instead as mass hysteria.

The onset of ORS may be sudden, where it usually follows after a precipitating event, or gradual.

Psychiatric co-morbidity in ORS is reported. Depression, which is often severe, may be a result of ORS, or may be pre-existing. Personality disorders, especially cluster C, and predominantly the avoidant type, may exist with ORS. bipolar disorder, schizophrenia, hypochondriasis, alcohol, drug abuse and obsessive compulsive disorder.

Object sexuality or objectophilia is a form of sexuality focused on particular inanimate objects. Those individuals with this expressed preference may feel strong feelings of attraction, love, and commitment to certain items or structures of their fixation. For some, sexual or even close emotional relationships with humans are incomprehensible. Some object-sexual individuals also often believe in animism, and sense reciprocation based on the belief that objects have souls, intelligence, and feelings, and are able to communicate.

Diagnosis of a specific type of delusional disorder can sometimes be made based on the content of the delusions. The "Diagnostic and Statistical Manual of Mental Disorders" (DSM) enumerates seven types:

- Erotomanic type (erotomania): delusion that another person, often a prominent figure, is in love with the individual. The individual may breach the law as he/she tries to obsessively make contact with the desired person.

- Grandiose type: delusion of inflated worth, power, knowledge, identity or believes themself to be a famous person, claiming the actual person is an impostor or an impersonator.

- Jealous type: delusion that the individual's sexual partner is unfaithful when it is untrue. The patient may follow the partner, check text messages, emails, phone calls etc. in an attempt to find "evidence" of the infidelity.

- Persecutory type: This delusion is a common subtype. It includes the belief that the person (or someone to whom the person is close) is being malevolently treated in some way. The patient may believe that he/she has been drugged, spied upon, harassed and so on and may seek "justice" by making police reports, taking court action or even acting violently.

- Somatic type: delusions that the person has some physical defect or general medical condition

- Mixed type: delusions with characteristics of more than one of the above types but with no one theme predominating.

- Unspecified type: delusions that cannot be clearly determined or characterized in any of the categories in the specific types.

In psychiatry, thought withdrawal is the delusional belief that thoughts have been 'taken out' of the patient's mind, and the patient has no power over this. It often accompanies thought blocking. The patient may experience a break in the flow of their thoughts, believing that the missing thoughts have been withdrawn from their mind by some outside agency. This delusion is one of Schneider's first rank symptoms for schizophrenia. Because thought withdrawal is characterized as a delusion, according to the DSM-IV TR it represents a positive symptom of schizophrenia.

In 2009 Amy Marsh, a clinical sexologist, surveyed the twenty-one English-speaking members of Erika Eiffel's 40-strong OS Internationale about their experiences. About half reported autism spectrum disorders: six had been diagnosed, four were affected but not diagnosed, and three of the remaining nine reported having "some traits." According to Marsh, "The emotions and experiences reported by OS people correspond to general definitions of sexual orientation," such as that in an APA article "on sexual orientation and homosexuality ... [which] refers to sexual orientation as involving 'feelings and self concept.'"

The following can indicate a delusion:

1. The patient expresses an idea or belief with unusual persistence or force.

2. That idea appears to have an undue influence on the patient's life, and the way of life is often altered to an inexplicable extent.

3. Despite his/her profound conviction, there is often a quality of secretiveness or suspicion when the patient is questioned about it.

4. The individual tends to be humorless and oversensitive, especially about the belief.

5. There is a quality of "centrality": no matter how unlikely it is that these strange things are happening to him/her, the patient accepts them relatively unquestioningly.

6. An attempt to contradict the belief is likely to arouse an inappropriately strong emotional reaction, often with irritability and hostility.

7. The belief is, at the least, unlikely, and out of keeping with the patient's social, cultural, and religious background.

8. The patient is emotionally over-invested in the idea and it overwhelms other elements of their psyche.

9. The delusion, if acted out, often leads to behaviors which are abnormal and/or out of character, although perhaps understandable in the light of the delusional beliefs.

10. Individuals who know the patient observe that the belief and behavior are uncharacteristic and alien.

Additional features of delusional disorder include the following:

1. It is a primary disorder.

2. It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.

3. The illness is chronic and frequently lifelong.

4. The delusions are logically constructed and internally consistent.

5. The delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is usually no general disturbance of behavior. If disturbed behavior does occur, it is directly related to the delusional beliefs.

6. The individual experiences a heightened sense of self-reference. Events which, to others, are nonsignificant are of enormous significance to him or her, and the atmosphere surrounding the delusions is highly charged.

Delusional misidentification syndrome is an umbrella term, introduced by Christodoulou (in his book "The Delusional Misidentification Syndromes", Karger, Basel, 1986) for a group of delusional disorders that occur in the context of mental and neurological illness. They all involve a belief that the identity of a person, object, or place has somehow changed or has been altered. As these delusions typically only concern one particular topic, they also fall under the category called monothematic delusions.

This psychopathological syndrome is usually considered to include four main variants:

- The Capgras delusion is the belief that (usually) a close relative or spouse has been replaced by an identical-looking impostor.

- The Fregoli delusion is the belief that various people the believer meets are actually the same person in disguise.

- Intermetamorphosis is the belief that people in the environment swap identities with each other whilst maintaining the same appearance.

- Subjective doubles, described by Christodoulou in 1978 ("American Journal of Psychiatry" 135, 249, 1978), is the belief that there is a doppelgänger or double of him- or herself carrying out independent actions.

However, similar delusional beliefs, often singularly or more rarely reported, are sometimes also considered to be part of the delusional misidentification syndrome. For example:

- Mirrored-self misidentification is the belief that one's reflection in a mirror is some other person.

- Reduplicative paramnesia is the belief that a familiar person, place, object, or body part has been duplicated. For example, a person may believe that they are in fact not in the hospital to which they were admitted, but an identical-looking hospital in a different part of the country, despite this being obviously false.

- The Cotard delusion is a rare disorder in which people hold a delusional belief that they are dead (either figuratively or literally), do not exist, are putrefying, or have lost their blood or internal organs. In rare instances, it can include delusions of immortality.

- Syndrome of delusional companions is the belief that objects (such as soft toys) are sentient beings.

- Clonal pluralization of the self, where a person believes there are multiple copies of him- or herself, identical both physically and psychologically but physically separate and distinct.

There is considerable evidence that disorders such as the Capgras or Fregoli syndromes are associated with disorders of face perception and recognition. However, it has been suggested that all misidentification problems exist on a continuum of anomalies of familiarity, from déjà vu at one end to the formation of delusional beliefs at the other.

Aversion to happiness, also called cherophobia or fear of happiness, is an attitude towards happiness in which individuals may deliberately avoid experiences that invoke positive emotions or happiness.

One of several reasons that cherophobia may develop is the belief that when one becomes happy, a negative event will soon occur that will taint their happiness, as if that individual is being punished for satisfaction. This belief is thought to be more prevalent in non-Western cultures. In Western cultures, such as American culture, "it is almost taken for granted that happiness is one of the most important values guiding people’s lives." Western cultures are more driven by an urge to maximize happiness and minimize sadness. Failing to appear happy is often a cause for concern. Its value is echoed through Western positive psychology and research on subjective well-being.. Fear of happiness is associated with fragility of happiness beliefs, suggesting that one of the causes of aversion to happiness may be the belief that happiness is unstable and fragile . Fear of happiness has also been linked to avoidant and anxious attachment styles.

Ghost sickness is a cultural belief among some traditional indigenous peoples in North America, notably the Navajo, and some Muscogee and Plains cultures, as well as among Polynesian peoples. People who are preoccupied and/or consumed by the deceased are believed to suffer from ghost sickness. Reported symptoms can include general weakness, loss of appetite, suffocation feelings, recurring nightmares, and a pervasive feeling of terror. The sickness is attributed to ghosts () or, occasionally, to witches or witchcraft. Children are thought to be especially at risk of being affected because they are not as attached to their new bodies.

Studies of borderline children often uncovered at the base of their self-destructive behaviour patterns ' a "fixed fantasy"...a rigid, nonreflective scenario of self-induced pain'. As part of a psychic defence mechanism, 'the omnipotence betrayed by the "fixed fantasy" underlying self-victimization or other forms of self-defeating behaviour...creates the illusory sense that they are actively producing the abandonment [&] pain', rather than merely suffering it passively - 'arranging deceits..arrang[ing] for blows to fall'. Unfortunately 'in the course of development, these patterns acquire multiple adaptive functions...and serve as a key organizer of their sense of self'.

'In producing movement away from fixed fantasy systems, commonplace statements are often necessary because the more fixed and extensive the fantasy system, the fewer the transitional opportunities offered; there is little conflicting material to ride. Banalities may be the only resource', as anything more complex may be used to feed back into the fantasy system itself.

A monothematic delusion is a delusional state that concerns only one particular topic. This is contrasted by what is sometimes called "multi-thematic" or "polythematic" delusions where the person has a range of delusions (typically the case of schizophrenia). These disorders can occur within the context of schizophrenia or dementia or they can occur without any other signs of mental illness. When these disorders are found outside the context of mental illness, they are often caused by organic dysfunction as a result of traumatic brain injury, stroke, or neurological illness.

People who experience these delusions as a result of organic dysfunction often do not have any obvious intellectual deficiency nor do they have any other symptoms. Additionally, a few of these people even have some awareness that their beliefs are bizarre, yet they cannot be persuaded that their beliefs are false.

In psychiatry, thought broadcasting is the belief that others can hear or are aware of an individual's thoughts. This differs from telepathy in that the thoughts being broadcast are thought to be available to anybody.

Thought broadcasting can be a positive symptom of schizophrenia. Thought broadcasting has been suggested as one of the first rank symptoms (Schneider's first-rank symptoms) believed to distinguish schizophrenia from other psychotic disorders.

In mild manifestations, a person with this thought disorder may doubt their perception of thought broadcasting. When thought broadcasting occurs on a regular basis, the disorder can affect behavior and interfere with the person's ability to function in society. According to an individual's personality this is considered to be a severe manifestation of thought broadcasting that is usually indicative of schizophrenia.

Delusions – fixed, fallacious beliefs – are symptoms that, in the absence of organic disease, indicate psychiatric disease. The content of delusions varies considerably (limited by the imagination of the delusional person), but certain themes have been identified; for example persecution. These themes have diagnostic importance in that they point to certain diagnoses. Persecutory delusions are, for instance, classically linked to psychosis.

The delusions that fall under this category are:

- Capgras delusion: the belief that (usually) a close relative or spouse has been replaced by an identical-looking impostor.

- Fregoli delusion: the belief that various people whom the believer meets are actually the same person in disguise.

- Intermetamorphosis: the belief that people in one's environment swap identities with each other while maintaining the same appearance.

- Subjective doubles: a person believes there is a doppelgänger or double of him- or herself carrying out independent actions.

- Cotard delusion: the belief that oneself is dead or does not exist; sometimes coupled with the belief that one is putrefying or missing internal organs.

- Mirrored-self misidentification: the belief that one's reflection in a mirror is some other person.

- Reduplicative paramnesia: the belief that a familiar person, place, object, or body part has been duplicated. For example, a person may believe that they are, in fact, not in the hospital to which they were admitted, but in an identical-looking hospital in a different part of the country.

- Somatoparaphrenia: the delusion where one denies ownership of a limb or an entire side of one's body (often connected with stroke).

Note that some of these delusions are sometimes grouped under the umbrella term of delusional misidentification syndrome.

Although non-specific concepts of madness have been around for several thousand years, the psychiatrist and philosopher Karl Jaspers was the first to define the three main criteria for a belief to be considered delusional in his 1913 book "General Psychopathology". These criteria are:

- certainty (held with absolute conviction)

- incorrigibility (not changeable by compelling counterargument or proof to the contrary)

- impossibility or falsity of content (implausible, bizarre, or patently untrue)

Furthermore, when a false belief involves a value judgment, it is only considered a delusion if it is so extreme that it cannot be, or never can be proven true. For example: a man claiming that he flew into the sun and flew back home. This would be considered a delusion, unless he were speaking figuratively, or if the belief had a cultural or religious source.

A delusion is a mistaken belief that is held with strong conviction even when presented with superior evidence to the contrary. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, or some other misleading effects of perception.

Delusions typically occur in the context of neurological or psychiatric disease, although they are not tied to any particular disorder and have been found to occur in the context of many pathological states (both physical and mental). However, they are of particular diagnostic importance in psychotic disorders including schizophrenia, paraphrenia, manic episodes of bipolar disorder, and psychotic depression.

Signs and symptoms of Fregoli's:

- delusions

- visual memory deficit

- deficit in self-monitoring

- deficit in self-awareness

- hallucinations

- deficit in executive functions

- deficit in cognitive flexibility

- history of seizure activity

- epileptogenic activity

In Scientology, an implant is a form of Thought insertion, similar to an engram but done deliberately and with evil intent. It is "an intentional installation of fixed ideas, contra-survival to the thetan".

The intention in the original engram or incident is to implant an idea or emotion or sensation, regarding some phenomenon etc. The intention in Scientology and Dianetics is to erase the compulsive or command effect of the idea, emotion, sensation, etc. so that the person can make a rational judgment and decision in the affected areas of life.

Scientology practices often have to do with addressing implants prior to the current lifetime — one of the most notable is the "R6 implant"; but in some cases current life implants are addressed. Examples of implants according to Scientology include Aversion therapy, Electroconvulsive therapy, hypnosis, various attempts at brainwashing, and the inducing of fear or terror. Note that this is not a complete list, as many kinds of incidents can include implants as an element.

Other important implants in Scientology doctrine include the Helatrobus implants, which Hubbard claimed occurred 382 trillion years ago to 52 trillion years ago by an alien nation called the Helatrobans, who sought to restrain human minds by capturing and brainwashing thetans. These implants are said to be responsible for the concept of Heaven.