Authors: Daniel Freeman Philippa Garety
Publish Date: 2014/07/09
Volume: 49, Issue: 8, Pages: 1179-1189
Abstract
Persecutory delusions are a central psychotic experience at the severe end of a paranoia spectrum in the general population The aim of the review is to provide an introduction to the understanding of persecutory delusions highlight key putative causal factors that have the potential to be translated into efficacious treatment and indicate future research directionsSix main proximal causal factors are identified a worry thinking style negative beliefs about the self interpersonal sensitivity sleep disturbance anomalous internal experience and reasoning biases Each has plausible mechanistic links to the occurrence of paranoia These causal factors may be influenced by a number of social circumstances including adverse events illicit drug use and urban environmentsThere have been numerous replicated empirical findings leading to a significant advance in the understanding of persecutory delusions now beginning to be translated into cognitive treatments The first trials specifically focussed on patients who have persecutory delusions in the context of psychotic diagnoses are occurring Initial evidence of efficacy is very promisingTwo distressing concerns are at the heart of persecutory delusions harm is going to occur and others intend it 2 Almost half of individuals with persecutory delusions have levels of psychological wellbeing in the lowest 2 of the general population 3 The delusions are typically accompanied by anxiety 4 depression 5 and disturbed sleep 6 A personal account by Weiner 7 notes ‘What I remember most is how disoriented and frightened I felt’ At first episode of psychosis over 70 of patients have a persecutory delusion 8 9 It is the type of delusion most likely to be acted upon 10 Persecutory delusions are a common clinically important psychotic experience for which treatments need to be significantly improved We advocate the approach of understanding the causes to translate this knowledge into efficacious treatment 11
Keywords: