Acting on delusions in patients suffering from schizophrenia

Abstract

Background: Schizophrenia patients are more prone to violent crimes because of associated risk factors – delusions, hallucinations, and substance misuse. The phenomenology of delusions associated with action provides a new way of understanding delusions and identifying key targets for risk management intervention secondary to medications. Aims: To assess the prevalence of delusional action in patients suffering from Schizophrenia and to identify the phenomenological characteristics of those delusions which are associated with action. Materials and method: A cross-sectional study was conducted on a sample of 77 patients and their informant using DSM – 5 diagnostic criteria for Schizophrenia and Maudsley Assessment of Delusion Schedule was applied. Results: Fifty one (66.2%) acted on their delusions. Delusion of persecution was commonest being present in 58.4%. Actions on delusions consisted of protecting themselves (32.5%), losing temper (25.9%), hitting self/ others (12.9%), moving/leaving house (15.6%), trying to stop it (27.2%). Informants reported that the patients felt unsafe, frightened or scared at home, suspicious of others, violent to someone, showed unusual behavior. Discussion: Acting on delusion occurs in significant proportion of patients. Significant association was found with acting on delusion and feeling angry. Besides significant association was observed between informant report of patients’ feeling frightened or scared at home and violent behavior to others with acting on delusion. Conclusions: Content of behavior can help understand the treating physician the probable precipitating factor, the psychopathology of the patient’s illness.