The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors
BackgroundThe period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding.AimsTo inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2019-09-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S205647241900067X/type/journal_article |
| _version_ | 1827995695444918272 |
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| author | Daniel Freeman Anthony Morrison Jessica C. Bird Eleanor Chadwick Emily Bold Kathryn M. Taylor Rowan Diamond Nicola Collett Emma Černis Louise Isham Rachel Lister Miriam Kirkham Ashley-Louise Teale Eve Twivy Felicity Waite |
| author_facet | Daniel Freeman Anthony Morrison Jessica C. Bird Eleanor Chadwick Emily Bold Kathryn M. Taylor Rowan Diamond Nicola Collett Emma Černis Louise Isham Rachel Lister Miriam Kirkham Ashley-Louise Teale Eve Twivy Felicity Waite |
| author_sort | Daniel Freeman |
| collection | DOAJ |
| description | BackgroundThe period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding.AimsTo inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from a cognitive model – before delusion onset.MethodA total of 100 patients with persecutory delusions completed a checklist about their subjective experiences in the weeks before belief onset. The checklist included items concerning worry, images, low self-esteem, poor sleep, mood dysregulation, dissociation, manic-type symptoms, aberrant salience, hallucinations, substance use and stressors. Time to reach certainty in the delusion was also assessed.ResultsMost commonly it took patients several months to reach delusion certainty (n = 30), although other patients took a few weeks (n = 24), years (n = 21), knew instantly (n = 17) or took a few days (n = 6). The most frequent experiences occurring before delusion onset were: low self-confidence (n = 84); excessive worry (n = 80); not feeling like normal self (n = 77); difficulties concentrating (n = 77); going over problems again and again (n = 75); being very negative about the self (n = 75); images of bad things happening (n = 75); and sleep problems (n = 75). The average number of experiences occurring was high (mean 23.5, s.d. = 8.7). The experiences clustered into six main types, with patients reporting an average of 5.4 (s.d. = 1.0) different types.ConclusionsPatients report numerous different experiences in the period before full persecutory delusion onset that could be contributory causal factors, consistent with a complex multifactorial view of delusion occurrence. This study, however, relied on retrospective self-report and could not determine causality.Declaration of interestNone. |
| first_indexed | 2024-04-10T05:00:23Z |
| format | Article |
| id | doaj.art-86677354b74e445d9de91979f40d315e |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T05:00:23Z |
| publishDate | 2019-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-86677354b74e445d9de91979f40d315e2023-03-09T12:28:55ZengCambridge University PressBJPsych Open2056-47242019-09-01510.1192/bjo.2019.67The weeks before 100 persecutory delusions: the presence of many potential contributory causal factorsDaniel Freeman0https://orcid.org/0000-0002-2541-2197Anthony Morrison1Jessica C. Bird2https://orcid.org/0000-0001-9457-1506Eleanor Chadwick3Emily Bold4Kathryn M. Taylor5Rowan Diamond6Nicola Collett7Emma Černis8Louise Isham9https://orcid.org/0000-0003-1752-5236Rachel Lister10Miriam Kirkham11Ashley-Louise Teale12Eve Twivy13Felicity Waite14https://orcid.org/0000-0002-2749-1386Professor of Clinical Psychology, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKProfessor of Clinical Psychology, Greater Manchester Mental Health NHS Foundation Trust; and Division of Psychology and Mental Health, University of Manchester, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKDepartment of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKDepartment of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Clinical Psychologist, University of Oxford; and Oxford Health NHS Foundation Trust, UKBackgroundThe period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding.AimsTo inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from a cognitive model – before delusion onset.MethodA total of 100 patients with persecutory delusions completed a checklist about their subjective experiences in the weeks before belief onset. The checklist included items concerning worry, images, low self-esteem, poor sleep, mood dysregulation, dissociation, manic-type symptoms, aberrant salience, hallucinations, substance use and stressors. Time to reach certainty in the delusion was also assessed.ResultsMost commonly it took patients several months to reach delusion certainty (n = 30), although other patients took a few weeks (n = 24), years (n = 21), knew instantly (n = 17) or took a few days (n = 6). The most frequent experiences occurring before delusion onset were: low self-confidence (n = 84); excessive worry (n = 80); not feeling like normal self (n = 77); difficulties concentrating (n = 77); going over problems again and again (n = 75); being very negative about the self (n = 75); images of bad things happening (n = 75); and sleep problems (n = 75). The average number of experiences occurring was high (mean 23.5, s.d. = 8.7). The experiences clustered into six main types, with patients reporting an average of 5.4 (s.d. = 1.0) different types.ConclusionsPatients report numerous different experiences in the period before full persecutory delusion onset that could be contributory causal factors, consistent with a complex multifactorial view of delusion occurrence. This study, however, relied on retrospective self-report and could not determine causality.Declaration of interestNone.https://www.cambridge.org/core/product/identifier/S205647241900067X/type/journal_articleWorryself-esteemaberrant saliencedissociationsleep problems |
| spellingShingle | Daniel Freeman Anthony Morrison Jessica C. Bird Eleanor Chadwick Emily Bold Kathryn M. Taylor Rowan Diamond Nicola Collett Emma Černis Louise Isham Rachel Lister Miriam Kirkham Ashley-Louise Teale Eve Twivy Felicity Waite The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors BJPsych Open Worry self-esteem aberrant salience dissociation sleep problems |
| title | The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors |
| title_full | The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors |
| title_fullStr | The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors |
| title_full_unstemmed | The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors |
| title_short | The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors |
| title_sort | weeks before 100 persecutory delusions the presence of many potential contributory causal factors |
| topic | Worry self-esteem aberrant salience dissociation sleep problems |
| url | https://www.cambridge.org/core/product/identifier/S205647241900067X/type/journal_article |
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