Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers

Background A persecutory delusion (severe paranoia) occurs when a person believes that others are trying to harm them when they are not. It is often a central difficulty for patients diagnosed with schizophrenia.Objective The objective is to identify potentially important research questions about se...

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Main Authors: Alvaro Barrera, Daniel Freeman, Thomas Kabir, Felicity Waite, Louise Isham, Poppy Brown, Pauline Dixon, David Ariel Sher, Maurice Arbuthnott, Suzie Nettleton, Joanna May, Sarah Reeve
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Mental Health
Online Access:https://mentalhealth.bmj.com/content/27/1/e301224.full
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author Alvaro Barrera
Daniel Freeman
Thomas Kabir
Felicity Waite
Louise Isham
Poppy Brown
Pauline Dixon
David Ariel Sher
Maurice Arbuthnott
Suzie Nettleton
Joanna May
Sarah Reeve
author_facet Alvaro Barrera
Daniel Freeman
Thomas Kabir
Felicity Waite
Louise Isham
Poppy Brown
Pauline Dixon
David Ariel Sher
Maurice Arbuthnott
Suzie Nettleton
Joanna May
Sarah Reeve
author_sort Alvaro Barrera
collection DOAJ
description Background A persecutory delusion (severe paranoia) occurs when a person believes that others are trying to harm them when they are not. It is often a central difficulty for patients diagnosed with schizophrenia.Objective The objective is to identify potentially important research questions about severe paranoia.Methods A priority-setting partnership exercise was conducted involving people with lived experience, carers, mental health staff, and researchers. An initial survey identified research questions, and a second survey prioritised a refined list of questions. There was a project steering group.Findings 1480 responses were gathered from 146 people (56 people with lived experience, 23 family members, 78 mental health staff, and 21 researchers). Following refinement, 201 questions were rated by the steering group for priority to enter the second survey. 38 questions were rated in the second survey by 157 people (69 people with lived experience, 33 family members, 59 mental health staff, and 27 researchers). 15 questions were identified as research priorities, each endorsed to a largely similar extent across stakeholder groups. These covered a wide range of topics, including how to support family and carers, understanding the causes of paranoia, managing paranoid thoughts day-to-day, improving access to services, and developing psychological and pharmacological approaches.Conclusions There was a good deal of consensus in key questions—covering many aspects of understanding, treatment, and support—to be answered about severe paranoia. Most questions were considered largely equally important.Clinical implications Numerous questions were identified that, if addressed, might improve clinical provision for persecutory delusions.
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spelling doaj-art-91c6dd4995fc4f79b58b86d6530113422024-12-16T13:30:09ZengBMJ Publishing GroupBMJ Mental Health2755-97342024-12-0127110.1136/bmjment-2024-301224Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchersAlvaro Barrera0Daniel Freeman1Thomas Kabir2Felicity Waite3Louise Isham4Poppy Brown5Pauline Dixon6David Ariel Sher7Maurice Arbuthnott8Suzie Nettleton9Joanna May10Sarah Reeve11Oxford Health NHS Foundation Trust, Oxford, UKDepartment of Experimental Psychology, University of Oxford, Oxford, UKDepartment of Experimental Psychology, University of Oxford, Oxford, UKDepartment of Experimental Psychology, University of Oxford, Oxford, UKOxford Health NHS Foundation Trust, Oxford, UKOxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UKAdvisory Group, Oxford, UKDepartment of Experimental Psychology, University of Oxford, Oxford, UKAdvisory Group, Oxford, UKAdvisory Group, Oxford, UKBerkshire Healthcare NHS Foundation Trust, Bracknell, Bracknell Forest, UKNorwich Medical School, University of East Anglia, Norwich, UKBackground A persecutory delusion (severe paranoia) occurs when a person believes that others are trying to harm them when they are not. It is often a central difficulty for patients diagnosed with schizophrenia.Objective The objective is to identify potentially important research questions about severe paranoia.Methods A priority-setting partnership exercise was conducted involving people with lived experience, carers, mental health staff, and researchers. An initial survey identified research questions, and a second survey prioritised a refined list of questions. There was a project steering group.Findings 1480 responses were gathered from 146 people (56 people with lived experience, 23 family members, 78 mental health staff, and 21 researchers). Following refinement, 201 questions were rated by the steering group for priority to enter the second survey. 38 questions were rated in the second survey by 157 people (69 people with lived experience, 33 family members, 59 mental health staff, and 27 researchers). 15 questions were identified as research priorities, each endorsed to a largely similar extent across stakeholder groups. These covered a wide range of topics, including how to support family and carers, understanding the causes of paranoia, managing paranoid thoughts day-to-day, improving access to services, and developing psychological and pharmacological approaches.Conclusions There was a good deal of consensus in key questions—covering many aspects of understanding, treatment, and support—to be answered about severe paranoia. Most questions were considered largely equally important.Clinical implications Numerous questions were identified that, if addressed, might improve clinical provision for persecutory delusions.https://mentalhealth.bmj.com/content/27/1/e301224.full
spellingShingle Alvaro Barrera
Daniel Freeman
Thomas Kabir
Felicity Waite
Louise Isham
Poppy Brown
Pauline Dixon
David Ariel Sher
Maurice Arbuthnott
Suzie Nettleton
Joanna May
Sarah Reeve
Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
BMJ Mental Health
title Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
title_full Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
title_fullStr Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
title_full_unstemmed Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
title_short Potential research priorities for understanding and treating severe paranoia (persecutory delusions): a priority-setting partnership between patients, carers, mental health staff, and researchers
title_sort potential research priorities for understanding and treating severe paranoia persecutory delusions a priority setting partnership between patients carers mental health staff and researchers
url https://mentalhealth.bmj.com/content/27/1/e301224.full
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