Delusions of reference

It is essential to differentiate between the delusions of reference so common in schizophrenic conditions and ideas of referetice as experienced in some of the personality disorders. In schizotypal personality disorder, social withdrawal from family and friends is common, accompanied by ideas of reference. An idea of reference is much more individualized than a delusion of reference. An idea of reference often refers to a specific individual, event, or item that can encompass magical thinking or involve a certain degree of exaggerated importance. An example of this is the client who believes she is so useless and worthless that a physician would come into her home and offer to assist in ending her life. Other areas of her life are not affected by such beliefs. This is very different from... 

A 25-year-old woman with a history of narcolepsy took modafinil, titrated up to 300 mg/ day, and had dry mouth and tachycardia. After 5 days, she continued to take 300 mg/ day without any apparent adverse effects. About 6 months later she had visual and auditory hallucinations and delusions of reference. Modafinil was withdrawn and her psychotic symptoms resolved. After restarting modafinil on alternate days occasional hallucinations recurred. 

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