The past and future of delusions research

from the inexplicable to the treatable

Garety, P. A.
Freeman, D.

P. A. Garety, MA, MPhil, MA (Ed), PhD, FBPsS, Department of Psychology, Institute of Psychiatry, King's College London; D. Freeman, PhD, DClinPsy, CPsychol, FBPsS, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK

Correspondence: Professor P. A. Garety, Box PO77, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. Email: [email protected]

Declaration of interest: None.

First received 9 Aug 2012, final revision 25 Jan 2013, accepted 23 May 2013

British Journal of Psychiatry 203(5):p 327-333, November 2013.

Background

Problems with the diagnosis and treatment of schizophrenia have led for a call to change strategy and focus on individual psychotic experiences. In recent years, research on delusions has led the way.

Aims

To update our 1999 review of almost 40 studies on delusions.

Method

A systematic literature search was conducted of reasoning and affective processes related to delusions.

Results

Over 200 studies were identified. The presence of ‘jumping to conclusions’ in individuals with delusions has been substantiated, the theory of mind account has not stood up to subsequent testing, and there is a promising new focus on the ways that affective processes contribute to delusional experience.

Conclusions

Theoretical work rendering delusions understandable can be translated into treatment; future clinical trials should focus on individual psychotic experiences as outcomes.