Persecutory delusion

Persecutory delusion
Other names	Paranoid delusion[1]
Specialty	Psychiatry, clinical psychology
Symptoms	False beliefs that one will be harmed, violent behaviour, theory of mind deficits, safety behaviours, low self-esteem, rumination
Complications	Premature death, heart disease, diabetes, high blood pressure, anxiety, depression, sleep disturbance
Causes	Mental illness (schizophrenia, delusional disorder, schizoaffective disorder), emotional abuse, drugs and alcohol use, family history
Differential diagnosis	Delusions of guilt or sin[1] and paranoid personality disorder
Treatment	Antipsychotics, cognitive behavioral therapy, vitamin B12 supplements

A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders.

Persecutory delusion is at the more severe side of the paranoia spectrum and it induces multiple complications, from anxiety to suicidal ideation. Persecutory delusion have a high percentage to be acted upon, such as not leaving the house due to fear or acting violently. The persecutory type is a common delusion and is more prevalent in males.

The causality of persecutory delusions are a combination of genetic (family history) and environmental (drug and alcohol use, emotional abuse) factors. This type of delusion is treatment-resistant. The most common methods of treatment are cognitive behavioral therapy, medications, namely first and second generation antipsychotics, and in severe cases, hospitalization. The diagnosis of the condition can be made using the DSM-5 or the ICD-11.