But what makes the content of a delusion persecutory in nature? Psychologists Dr Daniel Freeman and Professor Philippa Garety, conclude that suspicion results in the context of emotional distress. Central beliefs about oneself, others and the world in which we live all influence how we interpret events. The authors suggest that anxiety is a particularly important factor as this provides the element of threat in delusion formation. The way the person applies reason to their situation is another critical factor. The authors suggest that the intensity of a delusion becomes greater due to a variety of ‘reasoning biases' which shift a state of suspicion to certainty. As a result, the person is likely to behave in ways to ensure their safety, such as hiding away from social contact.

Paranoid schizophrenia can vary in its intensity and duration. Conventional treatments using antipsychotic medication can be problematic as medication may be viewed with suspicion. It is often useful for the person to have a structured supportive environment during the most difficult times, which is often in hospital settings or day care facilities. Some success has also been found in the use of Cognitive Behavior Therapy (CBT) specifically designed for psychosis. Some authors contend that the prognosis for paranoid schizophrenia is fairly good, particularly if the onset is late and the symptoms relatively mild.

Sources:

Bayley, R. (1996) First person account: schizophrenia. Schizophrenia Bulletin, 22, 727-729.

Davey, G. (2008) Clinical Psychology. Hodder Education.

Freeman, D. & Garety, A (2004) Bats Amongst Birds. The Psychologist. 17 (11) 642-645