[5] In many instances of grandiosity, it is suitable to go for a fractional rather than a total modification, which permits those elements of the delusion that are central for self-esteem to be preserved.

[5] In a case study of more than 13,000 non-clinical and almost 3,000 clinical participants, Isham et al.[8] found that the primary sources of meaning derived from grandiose delusions were:[8] Schizophrenia is a mental disorder distinguished by a loss of contact with reality and the occurrence of psychotic behaviors, including hallucinations and delusions (unreal beliefs which endure even when there is contrary evidence).

[12] Bipolar 1 disorder can lead to severe affective dysregulation, or mood states that sway from exceedingly low (depression) to exceptionally high (mania).

Typically, when experiencing or displaying a stage of heightened excitability called mania, they can experience joy, rage, and other intense emotions that can cycle out of control, along with thoughts or beliefs that are grandiose.

Some of these grandiose thoughts can be expressed as strong beliefs that the patient is very rich or famous or has super-human abilities, or can even lead to severe suicidal ideations.

[16] Psychologists and psychiatrists have proposed multiple theoretical accounts of GDs:[17] Empirical evidence largely supports emotion-consistent models, but also suggests additional factors like reasoning biases.

[18] Grandiose delusions are usually associated with high self-esteem and self-serving attributional style and low levels of depression, anxiety and negative self-evaluation.

[8][17][19][20] Moreover, there is evidence that repetitive positive self-thinking can confer temporary increases in (non-delusional) grandiose ideas of own superiority, importance or uniqueness.

[22] Qualitative research likewise indicates that grandiose delusions, far from occurring against a backdrop of negative self-evaluation, conferred a sense of uniqueness, purpose, and belonging, and added meaning to adverse events.

[23] The defensive hypothesis bears a strong similarity to the psychodynamic mask model of non-delusional narcissistic grandiosity,[24] which is also unsupported by the evidence.

[36] Vitamin B12 deficiency,[37] uremia,[38] hyperthyroidism[39] as well as the carcinoid syndrome[40] have been found to cause secondary mania, and thus grandiose delusions.

[41] Cognitive behavioral intervention is a form of psychological therapy, initially used for depression,[42] but currently used for a variety of different mental disorders, in hope of providing relief from distress and disability.

[44] Patients with mental disorders that experience grandiose delusions have been found to have a lower risk of having suicidal thoughts and attempts.