Schizophrenia delusions are false beliefs that people hold despite evidence that they are not true. The most common type is delusions of persecution, which involve a belief that a person or group is harming or harassing them.

Other types of schizophrenia delusions include grandiose, which is a belief that they are a famous individual, and reference, the belief that a neutral event is sending them a message. Another type is delusions of control, which is a belief that an outside force is controlling their thoughts.

Schizophrenia and related conditions affect an estimated 0.25–0.64%. of the United States population.

This article discusses schizophrenia delusions, including the types, treatment, and how to help those who experience them. It also examines the other symptoms of schizophrenia and when to contact a doctor.

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Schizophrenia is a mental health condition that causes individuals to interpret reality differently. One of the symptoms is delusions, which are false beliefs that people cannot change even if others present them with clear or reasonable evidence that they are not true. Delusions may involve illogical fantasies.

They are very common in schizophrenia, occurring in more than 90% of those with the condition.

Learn more about schizophrenia.

There are various types of schizophrenia delusions. These include:

  • Delusions of persecution: These entail a belief that others are out to get them and are frequently bizarre. They are the most common type.
  • Delusions of grandeur: These involve a belief that they are an important or famous individual such as Napoleon. They may also entail a belief that they have unusual powers.
  • Delusions of reference: These consist of a belief that a neutral event has a personal meaning. For example, they may think a billboard is sending them a special message.
  • Delusions of control: These involve a belief that outside forces are controlling their thoughts or actions. To illustrate, they may think, “Someone is planting thoughts in my head.”

Symptoms vary in type, severity, and frequency among people with schizophrenia, and they can change over time. Aside from delusions, they include:

  • Hallucinations: These involve hearing or seeing things that do not exist.
  • Disorganized speech or thinking: This entails speaking in sentences that do not make sense or shifting from one thought to another without a logical connection.
  • Abnormal or disorganized physical behavior: This involves inappropriate actions, repetitive actions, or a complete lack of talking or movement
  • Difficulty speaking and expressing emotions: A person may also have problems with memory, focusing attention, and organizing tasks.
  • Decreased ability to function as usual: For example, not showing emotions or neglecting personal hygiene.

Some of the most common warning signs of schizophrenia include:

  • suspiciousness
  • flat, expressionless gaze
  • depression
  • deterioration of personal hygiene
  • irrational or odd statements
  • inability to cry or express joy or inappropriate laughter
  • forgetful

Although such warning signs may stem from conditions other than schizophrenia, they merit a doctor’s attention. When out-of-the-ordinary behavior is causing an issue in an individual’s life or the life of a loved one, medical advice is necessary.

Lifelong treatment is necessary for schizophrenia delusions. However, the earlier it starts, the better the likelihood of improved quality of life. Medications and therapy can manage symptoms, and many people with the condition can pursue their goals and have productive lives.

Treatment options include:

  • Medications: These involve antipsychotic drugs, such as clozapine (Clozaril). However, a person may need to try different medications at different doses before a doctor determines what is most effective with the least side effects.
  • Electroconvulsive therapy: This is a brain stimulation technique that entails passing small electric currents through the brain.
  • Therapy: This may include individual or family therapy. Individual — or talk — therapy involves helping someone with delusions normalize thought patterns, cope with stress, and note early signs of relapse. Family therapy provides insight and support to family members.

The most important way of helping people with schizophrenia delusions involves urging them to get medical attention. As treatment may take time to take effect, it also helps to encourage them to engage in healthy lifestyle practices, which may help them feel better. These include:

  • getting regular exercise
  • eating a nutritious diet
  • getting plenty of sleep
  • avoiding alcohol, drugs, and nicotine

Additionally, when people with schizophrenia express delusions, the National Alliance on Mental Illness (NAMI) advises avoiding reinforcing or disputing them. Playing along with the delusion or trying to talk the individual out of it is not likely to help.

Instead, NAMI recommends validating but redirecting underlying fears. In other words, someone can explain that they see the situation differently without asserting that it is more rational.

Schizophrenia delusions are false beliefs that tend to involve illogical fantasies. The types of delusions include persecution, grandeur, reference, and control.

Other schizophrenia symptoms include hallucinations, disorganized thinking, unusual physical behavior, problems with expressing emotion, and decreased ability to function as usual.

Treatment may include medications and therapy.

If a person is experiencing a delusion, it is best to avoid reinforcing or refuting it. Instead, it may help to validate but redirect an underlying fear.

When a person or one of their loved ones experiences warning signs of schizophrenia — such as suspiciousness or an expressionless gaze — they should contact a doctor.