Acting on Delusions. I: Prevalence

Abstract

Associations between delusions and abnormal behaviour were retrospectively assessed in a sample of 83 consecutively admitted deluded subjects. All were interviewed about events in the previous month using a new measure of delusional phenomenology and action. For 59 subjects this information was supplemented by informant interviews. Clinical consensus was reached concerning the probability that actions reported by informants were linked to delusions. Half of the sample reported that they had acted at least once in accordance with their delusions. Violent behaviour in response to delusions was uncommon. Information provided by informants suggested that some aspect of the actions of half of the sample was either probably or definitely congruent with the content of their delusions. However, there was no link between self-reports and informants' reports of such action. A latent class analysis of self-reported delusional action suggested three classes of action, namely aggressive to self or other, defensive action, and either none or single action. Self-reported action was associated with delusions of catastrophe. Informant data suggested that persecutory delusions were the most likely to be acted upon, but in contrast delusions of guilt or catastrophe appeared to decrease the chance of delusional behaviour. Actions associated with abnormal beliefs are more common than has been suggested.

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

“…Stompe et al (1999) reported that persecution was the most common delusional belief type among 126 Austrian and 108 Pakistani people diagnosed with schizophrenia. Persecutory delusions are associated with strong negative affect, and are the delusion type most likely to be acted upon (Appelbaum, Robbins, & Roth, 1999;Wessely et al, 1993). The presence of persecutory delusions has been found to predict hospital admission on first contact with psychiatric services (Castle, Phelan, Wessely, & Murray, 1994).…”

Esquizofrenia, psicopatologia e crime violento: uma revisão das evidências empíricas

“…Delírios de grandeza e religioso relacionaram-se com aumento na convicção, enquanto delírios persecutórios foram fortemente marcados por afetos negativos e por propensão para agir (Appelbaum et al, 1999;Wessely et al, 1993). Comportamento desviante parece associar-se tanto ao grau de convicção do delírio como com a resposta afetiva a este (Dalgalarrondo et al, 2003).…”

Nonbizarre Delusions as Strategic Deception

“…Importantly, most do. Wessely et al [99] found that 60% of their sample of deluded individuals 6 reported at least one action based on delusion; third-party informants reported that 52% of the sample probably or definitely acted on delusions. Persecutory delusions were significantly more likely to be acted upon than other beliefs.…”

“…These are the most common type of delusions [9]. Individuals with these delusions can give very convincing accounts of the reputed threat, behave consistently with the delusion [99], and give cues of genuine fear and distress [100].…”