Treating persistent harmful grandiose delusions in patients attending NHS mental health services for the treatment of affective or non-affective psychosis. Mental and Behavioural Disorders
Conditions
Interventions
The intervention is a psychological therapy designed to precisely target the key mechanisms which drive grandiose delusions and reduce associated harm. Central to the therapy is helping patients find
Sponsors
University of Oxford
Eligibility
Sex/Gender
All
Age
16 Years to 110 Years
Inclusion criteria
Inclusion criteria: 1. Participant is willing and able to give informed consent for participation in the study 2. Aged 16 years or older 3. Attending NHS mental health services for the treatment of affective or non-affective psychosis 4. Persistent (at least 3 months) grandiose delusion (as defined by the Schedules for Clinical Assessment in Neuropsychiatry), held with at least 60% conviction 5. No planned significant medication changes at the outset of participation
Exclusion criteria
Exclusion criteria: 1. A primary diagnosis of another mental health condition (e.g. substance use disorder) that would be the first clinical priority to treat 2. Current engagement in any other intensive individual psychological therapy or a significant change in medication 3. In forensic settings or Psychiatric Intensive Care Unit (PICU) 4. Command of spoken English inadequate for engaging in the therapy 5. Significant learning difficulties that would prevent the completion of assessments or the therapy 6. A participant may also not enter the trial if there is another factor (for example, current active suicidal plans that need to be the focus of intervention), which, in the judgement of the investigator, would preclude the participant from providing informed consent or from safely engaging with the trial procedures. Reason for exclusion will be recorded
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Grandiose delusion severity measured using the Psychotic Symptom Rating Scale - Delusions subscale (PSYRATS delusions) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Grandiosity severity measured using Specific Psychotic Symptom Rating Scale - Grandiosity Subscale (SPEQ-G) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Grandiose delusion conviction measured using a 0-100% Visual Analogue Scale (VAS) at weekly timepoints throughout baseline and therapy phases and at two-week follow-up after therapy completion | — |
Secondary
| Measure | Time frame |
|---|---|
| Repetitive thinking about the grandiose delusions measured using the Thinking about Experiences of Feeling Exceptional Questionnaire (TEEQ) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Immersion Behaviours measured using Immersion Behaviours Questionnaire at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Meaning in Grandiose Delusions measured using the Grandiosity Meaning Measure (gram) and Grandiosity Meaning Measure - Sources (grams) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Anomalous experiences measured using the Specific Psychotic Experiences Questionnaire - anomalous experiences (SPEQ-AE) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Mania measured using the Internal State Scale at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Subjective harm from grandiose delusions measured using the Subjective Harm from Experiences of Feeling Exceptional Questionnaire (SHEEQ) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Brief idiographic measures (single item visual analogue scales) for repetitive thinking, immersion behaviours, meaning from grandiose delusions, anomalous experiences, mania, and subjective harm measured using the Brief single-item visual analogue scales at weekly timepoints throughout baseline and intervention phases and at two-week follow-up after the intervention has finished;Depression measured using the Patient Health Questionnaire-9 (PHQ-9) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Anxiety measured using the Generalized Anxiety Disorder-7 (GAD-7) at the start of baseline, the end of baseline, the mid therapy, and the end of therapy;Paranoia measured using the Revised Green et al Paranoid Thought Scale (RGPTS) at the start of baseline, the end of baseline, the mid the | — |
Countries
England, United Kingdom
Contacts
Public ContactLouise Isham
Outcome results
None listed