Recovery From Paranoia: a Qualitative Exploration

Paranoia, the experience of undue or excessive mistrust, exists on a continuum which includes suspicious thoughts, ideas of reference, and persecutory delusions. Persecutory delusions refers to strong unfounded fears that others intend harm. These fears are very common. They affect around 70% of patients with schizophrenia. They can be distressing and make day-to-day tasks difficult. However, current treatments are limited and a significant proportion of people do not benefit sufficiently. Therefore, improvements in treatment are needed. A better understanding of the experience of recovery from paranoia will help inform theoretical understanding and treatment development. Currently we do not fully understand what causes paranoia to occur, persist, or end. As such, it is critical to understand the experiences of those who have recovered, in particular what elements encourage recovery. Therefore, the aim of this study is to gain a first-person perspective on how people recover from paranoia and what psychological processes are important for recovery from paranoia. Using a qualitative approach appropriate for exploratory research, semi-structured interviews will be conducted with 12-15 patients who have recovered from paranoia. Interviews will be analysed using interpretative phenomenological analysis, a qualitative research approach which aims to provide insight on how an individual, in a particular situation, makes sense of their experience.

Study Overview

• Status: Completed
• Conditions: Persecutory Delusion; Paranoia
• Intervention / Treatment: Other: Qualitative interview

• Study Type: Observational
• Enrollment (Actual): 15

Contacts and Locations

Study Locations

• United Kingdom
  • Oxfordshire
    • Oxford, Oxfordshire, United Kingdom, OX3 7JX
      • Oxford Health NHS Foundation Trust

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A sample of approximately 15 patients who have recovered from paranoia will be recruited. Participants will be recruited according to the inclusion and exclusion criteria adumbrated below.

Description

Inclusion Criteria:

• Participant has recovered from the paranoia. This is defined as: A.) conviction in persecution beliefs is rated as less than 10% and B.) not experiencing significant distress related to paranoia and C.) currently scoring outside the clinical range of the revised Green et al., Paranoid Thoughts Scale (R-GPTS; Freeman, 2019);
• Participants should have had experiences of paranoia in the context of non-affective psychosis. This will be determined by participant's agreement that they previously had the sort of thoughts listed in the revised Green et al. Paranoid Thoughts Scale (R-GPTS; Freeman, 2019);
• Participant is currently a patient of Oxford Health NHS Foundation Trust;
• Participant is willing and able to give informed consent for participation in the study;
• Aged 16 years or above;
• Participant has sufficient English language skills to participate in the interview.

Exclusion Criteria:

The following exclusion criteria will apply based on concerns regarding risk and capacity to consent:

• Currently experiencing acute psychiatric symptoms which preclude ability to participate in a sustained interview;
• Diagnosis of a moderate to severe intellectual disability;
• High levels of associated risk to self or to others e.g. actively suicidal;
• Primary diagnosis of alcohol or drug misuse; personality disorder; significant forensic history;
• At the time of recruitment COVID-19 restrictions do not permit face-to-face interviews and the participant is not willing or able to conduct the interview remotely via video call.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Qualitative interview accounts	Semi-structured interpretative phenomenological analysis (IPA) interviews will be used.	March 2021-March 2022

Collaborators and Investigators

• Sponsor: University of Oxford
• Investigators: Study Director: Dr Felicity Waite, DClinPsy, BSc (Hons), University of Oxford

Study record dates

Study Major Dates

• Study Start (Actual): June 9, 2021
• Primary Completion (Actual): July 27, 2021
• Study Completion (Actual): February 16, 2022

Study Registration Dates

• First Submitted: March 25, 2021
• First Submitted That Met QC Criteria: March 30, 2021
• First Posted (Actual): April 1, 2021

Study Record Updates

• Last Update Posted (Actual): May 19, 2022
• Last Update Submitted That Met QC Criteria: May 18, 2022
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: Recovery; Qualitative; Paranoia; NHS; Persecutory delusions; Interpretative phenomenological analysis
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Schizophrenia Spectrum and Other Psychotic Disorders; Paranoid Disorders; Delusions
• Other Study ID Numbers: PID 15402; IRAS (Other Identifier: 332422); HRA (Other Identifier: 21/WA/0081)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No