Persecutory delusion

A persecutory delusion are persistent, distressing beliefs that one is or will be harmed, they continue even in the face of evidence. This condition is mainly seen on schizophrenia, schizoaffective disorder, delusional disorder[2] but can also be found on maniac episodes of bipolar disorder, psychotic depression and personality disorder.[3] Along side with delusional jealousy, persecutory are the most common types of delusion on males and are overall a frequent symptom of psychosis.[4][5] The delusions often times go with anxiety, depression, and disturbed sleep.[2] People with persecutory delusion have a increased difficult to attribute mental state to oneself and others and sometimes misread other people intentions because of it.[6][5]

The level of functionality of people who suffer from is considered normal[7] though people with this delusion are in the two lowest percent in terms of psychological well-being.[2] Correlation has been found between the higher the imagined power of the persecutor and the control over the delusion, the more severely depressed the person is.[1] In urban environments, going outside leads people with this delusion to have a major increases in levels of paranoia, anxiety, depression and lower self-esteem.[2] People with this delusion live a more inactive life and are at a higher risk of developing high blood pressure, diabetes and heart disease, because of this life expectancy is greatly impacted being 14.5 years shorter.[8]

Persecutory has the highest rate of all delusions to be acted upon, such as not leaving the house out of the fear of being harmed, or acting violently.[9][10] Safety behaviours are also frequently found, individuals who feel threatened perform actions in order to avert their feared delusion from occurring. Avoidance is commonly observed, people with this delusion might avoid going to the mall or the metro where they feared harm. Individuals also try to lessen the threat, such as only leaving the house with a trusted person, reduce their visibility by taking alternative routes, increase their vigilance by looking up and down the street, or acted as if they would resist attack by being prepared to strike out.[11]

A study assessing schizophrenia patients with persecutory delusions found remarkably higher levels of childhood emotional abuse within those people but found no diferences of trauma, physical abuse, physical neglect and sexual abuse.[12] Biological elements, such as chemical imbalances in the brain and alcohol and drug use are a contributing factor to persecutory delusions, genetic elements are also thought to influence, family members with schizophrenia and delusional disorder are at a higher risk of developing persecutory delusion.

Medications for schizophrenia are often used, especially when positive symptoms are present. Both first-generation antipsychotics and second-generation antipsychotics may be useful.[13] Since these delusions are often accompanied with worry, using cognitive behavioral therapy to tackle this thought has shown to reduce the frequency of the delusions itself, improvement of well-being and less rumination.[14] Vitamin B12 supplements have shown positive results in treating patients with persecutory delusion.[15]

Types of Delusional Disorders, according to the DSM-5.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) enumerates seven types of delusions and the International Classification of Diseases (ICD-11) defines fifteen types of delusions both including persecutory delusion. They state that it's a common type of delusion that includes the belief that the person or someone close to the person is being maliciously treated, this encompasses thoughts that oneself has been drugged, spied upon, harmed, mocked, cheated, conspired against, persecuted, harassed and so on and may procure justice by making reports, taking action or responding violently.[16]

Two psychologist, Daniel Freeman and Philippa Garety have advanced a diagnostic table for persecutory delusion divided in two criteria that must be met, the individual believes that harm is going to occur to oneself at the present or future and that the harm is made by a persecutor. There's also points of clarification, the delusion has to cause distress to the individual, only harm to someone close to the person doesn't count as a persecutory delusion, the individual must believe that the persecutor will attempt to harm him or her and delusions of reference do not count within the category of persecutory beliefs.[2]

When the focus is to remedy some injustice by legal action, persecutory delusions are sometimes called "querulous paranoia".[17] Querulous paranoia is found more frequently on males between 40 and 60 years old.[18]

In cases where reporters of stalking behavior have been judged to be making false reports, a majority of them were judged to be delusional.[19][20]