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Persecutory delusions (unfounded beliefs that others intend harm) occur in over 70% of patients with diagnoses of schizophrenia. Examples of such beliefs include: “My neighbours are spreading nasty rumours and tormenting me”, “An evil spirit is out to kill me”. This major psychotic experience is a key treatment target. The delusion has substantial impact for patients (and their families), including isolation, suicidal ideation, and hospital admission. Yet too many patients do not adequately respond to current treatments.

Translating advances in understanding the causes of the delusions into treatment, Professor Freeman has been developing a new targeted psychological intervention. During the NIHR Professorship the new treatment will be evaluated in a randomised controlled trial. The goal at this stage is recovery in persistent persecutory delusions for 50% of patients. Improvements in psychological well-being and activity levels are also predicted.

Work will also be carried out during the award to ready the intervention for implementation in the NHS. The promise is of a major improvement in outcome, using an intervention that patients want and that health professionals have the confidence to use.