What is a sign that a client may have delusions during the Mental Status Exam?

The presence of thoughts related to harming oneself or others can indeed be indicative of delusional thinking, especially when these thoughts are fixed, false beliefs not based in reality. In a clinical context, clients exhibiting such thoughts may hold an unfounded conviction that they are a danger to themselves or others, or they might believe in a grandiose sense of purpose that drives these harmful thoughts. This aligns with common characteristics of delusions, where the individual firmly believes in ideas that are out of touch with reality.

In contrast, while unusual grooming habits or obsessive behaviors regarding trivial matters may suggest underlying mental health issues or anxiety disorders, they do not specifically point to the presence of delusions. Hallucinations, on the other hand, refer to perceiving things that are not present, such as hearing voices or seeing things that others cannot, but they are distinct from delusions, which are false beliefs held by the person. Thus, indicating thoughts of self-harm or harm to others in the context of delusions provides a more accurate description of potential delusional thinking during a Mental Status Exam.