Abstract
AbstractDelusional beliefs are key symptoms of mental illness, and physicians over hundreds of years have attempted to understand and offer treatments for patients with such beliefs. In this chapter, the authors will explore the experience of delusional beliefs within the clinical context: i.e. with people who present to mental health services for help. The authors begin with definition of the descriptive psychopathology, prevalence and context in which delusional beliefs occur and their clinical relevance. Delusional beliefs have a core role in distress, depression and risk within psychosis. Real examples will be used to reflect on both the form delusional beliefs take and their personal content, concluding with treatment options and challenges.
Highlights
Delusional beliefs are key symptoms of mental illness, and physicians over hundreds of years have attempted to understand and offer treatments for patients with such beliefs
As we have previously rehearsed, depression can be experienced as a complex reaction to psychosis, including delusional beliefs and the impact of psychosis, thwarted escape, self stigma and internalised shame contributing to a pathway of suicidal thinking (Fig. 1.1): We have explored this model with qualitative methods using photo- elicitation, together with unstructured interviews, used to characterise
Psychiatrists are concerned with delusional beliefs because, as all physicians should be, they are interested in human experience and driven by a need to offer therapeutic options to people in need
Summary
At times family members advocating on someone’s behalf, present to health services in distress and seeking help. My personal and clinical experience makes me believe delusions are distinct from other, more helpful beliefs, and it is inhumane not to offer people evidence-based treatments for them. S.A.’s direct account captures the immediacy of delusional experience with eloquence and candour, and conveys the clinical need for intervention to alleviate distress, and the need for action in the face of real physical impact: S.A. had withheld food and fluid for a number of days. This is not a sustainable situation and medicine has this need for action in response to pain and suffering at its core. It is very evident that we should never lose help-seeking and alleviation of distress or risk as the cornerstone for a psychiatrist’s role in treating delusions
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