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First-person accounts of delusions

University of Newcastle, Newcastle

Anthony S. David, Professor of Cognitive Neuropsychiatry

Institute of Psychiatry, London SE5 8AF

AIMS AND METHOD

In order to investigate cognitive aspects of the experience of delusions, including onset and recovery, autobiographical accounts of schizophrenia were reviewed.

RESULTS

The sample was self-selected and biased towards women and highly-educated patients. The delusions described were usually gradual in onset and often occurred in the context of an odd or fearful mood, which was accompanied by distorted reasoning. Recovery was also gradual with an intermediate stage of reality-testing or fluctuation between belief and disbelief. Many patients retained residual aspects of delusional thinking after recovery. Most attributed their recovery to a combination of medication, psychotherapy, social support and personal coping strategies; some felt that their illness had enhanced their self-awareness or spirituality.

CLINICAL IMPLICATIONS

Further exploration of spontaneous coping strategies in recovery from delusions through personal accounts of illness would be valuable.