Persecutory delusion

Persecutory delusions are a set of delusional conditions in which the affected persons believe they are being persecuted, despite a lack of evidence. Specifically, they have been defined as containing two central elements:[1]

  1. The individual thinks that harm is occurring, or is going to occur.
  2. The individual thinks that the perceived persecutor has the intention to cause harm.

According to the DSM-IV-TR, persecutory delusions are the most common form of delusions in paranoid schizophrenia, where the person believes "he or she is being tormented, followed, tricked, spied on, or ridiculed", or that their food is being poisoned.[2][3] They are also often seen in schizoaffective disorder and, as recognized by DSM-IV-TR, constitute the cardinal feature of the persecutory subtype of delusional disorder, by far the most common. Delusions of persecution may also appear in manic and mixed episodes of bipolar disorder, polysubstance abuse, and severe depressive episodes with psychotic features, particularly when associated with bipolar illness.

When the focus is to remedy some injustice by legal action, persecutory delusions are sometimes called "querulous paranoia".[4]

In cases where reporters of stalking behavior have been judged to be making false reports, a majority of them were judged to be delusional.[5][6]

Treatment

Medications for schizophrenia are often used, especially when positive symptoms are present. Both first-generation antipsychotics and second-generation antipsychotics may be useful.[7] Cognitive behavioral therapy has also been used.[8]

gollark: <@665664987578236961> I don't particularly *want* to die and if some point you're trying to make starts by convincing me I shouldn't mind I'm probably going to ignore it.
gollark: (again, more if healthcare is overloaded)
gollark: I am still *somewhat* scared of something like a 2% risk of death.
gollark: Well, isn't comparatively bad.
gollark: Just because something *isn't bad now* doesn't mean it can't be bad *later*.

See also

References
  1. Freeman, D. & Garety, P.A. (2004) Paranoia: The Psychology of Persecutory Delusions. Hove: PsychoIogy Press. Page 13. ISBN 1-84169-522-X
  2. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. 2000. p. 299. ISBN 0-89042-025-4.
  3. Varsamis, J.; Adamson, J. D.; Sigurdson, W. F. (December 1972). "Schizophrenics with Delusions of Poisoning". The British Journal of Psychiatry. 121 (565): 673–675. doi:10.1192/bjp.121.6.673. ISSN 0007-1250. PMID 4648443.
  4. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. 2000. p. 325. ISBN 0-89042-025-4.
  5. "After eight uncertain cases were excluded, the false reporting rate was judged to be 11.5%, with the majority of false victims suffering delusions (70%)." Sheridan, L. P.; Blaauw, E. (2004). "Characteristics of False Stalking Reports". Criminal Justice and Behavior. 31: 55–72. doi:10.1177/0093854803259235.
  6. Brown, S. A. (2008). "The Reality of Persecutory Beliefs: Base Rate Information for Clinicians". Ethical Human Psychology and Psychiatry. 10 (3): 163–178. doi:10.1891/1559-4343.10.3.163. Collapsing across two studies that examined 40 British and 18 Australian false reporters (as determined by evidence overwhelmingly against their claims), these individuals fell into the following categories: delusional (64%), factitious/attention seeking (15%), hypersensitivity due to previous stalking (12%), were the stalker themselves (7%), and malingering individuals (2%) (Purcell, Pathe, & Mullen, 2002; Sheridan & Blaauw, 2004).
  7. Garety, Philippa A.; Freeman, Daniel B.; Bentall, Richard P. (2008). Persecutory delusions: assessment, theory, and treatment. Oxford [Oxfordshire]: Oxford University Press. p. 313. ISBN 978-0-19-920631-5.
  8. Kingdon, Daniel G.; Turkington, Douglas (1994). Cognitive-behavioral therapy of schizophrenia. New York: Guiford Press.
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