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A TRIAL MEASURED WHAT REDUCES PARANOID DELUSIONS
Persecutory Delusions Are Beliefs That Others Intend Harm
They Occur In Over 70 Percent Of Non Affective Psychosis
For Many Patients The Belief Persists Despite Antipsychotic Medication
Cognitive Therapy For Psychosis Has Changed Delusions Only Slightly
Therapy Aimed At A Single Problem Achieves Far More
Oxford Researchers Then Built A Programme Around Six Named Modules
A Randomised Trial Compared It Against Befriending In 130 Patients
This Part Covers What That Trial Measured
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE CLINIC 🛋️
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THE ONES NOBODY COULD TREAT 💊
Persecutory Delusions Are Rated With A Scale Called PSYRATS
One Item Records How Strongly The Belief Is Held
Conviction Runs From 0 To 100 Percent On That Item
Recovery In Trials Means Conviction Below 50 Percent
That Threshold Marks More Doubt Than Certainty
Antipsychotic Medication Often Leaves Conviction Above It
Persistent Meant At Least 60 Percent For Three Months
Psychological Therapy Was Tested Against Those Persistent Beliefs
Cognitive Behavioural Therapy For Psychosis Produced Small Changes
Its Effect On Delusions Averaged Near 0.3 In Cohen's d
Targeted Therapy For Social Anxiety Reached 1.56 In That Metric
The Difference Between Those Two Figures Prompted A New Design
Daniel Freeman And Colleagues At Oxford Built The Replacement
They Did Not Treat The Delusion As One Single Symptom
Each Factor Thought To Maintain The Belief Was Handled Separately
Sleep Was One Of Those Factors
Worry Was Another
Self Confidence And Voices Were Two More
Reasoning Was The Fifth
A Sixth Component Used Behavioural Tests In Feared Situations
Patients Selected Three Or Four Modules After Assessment
Sessions Ran Weekly For Roughly Six Months
The Programme Was Named Feeling Safe
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A TRIAL WITH REAL NUMBERS 🧪
The Trial Randomised 130 Patients Across Three English NHS Trusts
64 Received Feeling Safe And 66 Received Befriending
Befriending Meant Supportive Conversation On Neutral Topics
Nine Clinical Psychologists Delivered Both Conditions
Assessors Did Not Know Which Treatment A Patient Received
Recruitment Ran From February 2016 To July 2019
At Baseline 96 Percent Of Patients Were Taking Antipsychotics
Every Patient Had Held The Belief For At Least Three Months
The Primary Outcome Was Delusion Conviction At Six Months
Feeling Safe Cut Conviction By 10.69 Points More Than Befriending
The Confidence Interval Ran From 1.63 To 19.75 Points
That Comparison Returned A P Value Of 0.021
The Effect Size On Conviction Was 0.86 In Cohen's d
Delusion Severity Showed A Larger Figure Of 1.20
The Trial Also Counted How Many Fell Below 50 Percent
Six Month Data Came From 63 Patients In Each Arm
32 Of 63 Patients Reached That Point On Feeling Safe
Befriending Reached It In 22 Of 63 Patients
That Recovery Difference Was Not Statistically Significant
At Twelve Months Severity Still Favoured Feeling Safe At 0.87
Adverse Events Affected 16 Patients On The Programme
Befriending Recorded Events In 20 Patients
None Were Judged Related To Either Treatment
The Authors Called These The Largest Effects Reported So Far
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SLEEP AND WHAT IS STILL OPEN 🕊️
Sleep Was One Of The Six Modules In The Feeling Safe Programme
A Separate Trial Tested Sleep Treatment On Its Own
Researchers Randomised 3755 Students Across UK Universities
1891 Received Digital Therapy For Insomnia Called Sleepio
The Other 1864 Continued With Usual Practice
Six Online Sessions Ran About 20 Minutes Each
Insomnia Improved With An Effect Size Of 1.11
Paranoia Improved By Far Less At 0.19
Hallucinations Measured 0.24 On The Same Metric
Both Figures Count As Small By Convention
Their P Values Still Fell Below 0.0001
Sleep Accounted For 57.8 Percent Of The Paranoia Change
The Sample Was Students And Not Patients With Psychosis
All Measures Were Self Reported
Fewer Than Half In The Therapy Arm Finished The Ten Week Check
A Shorter Version Of Feeling Safe Came Later
It Was Named Feeling Safer And Tested On 14 Patients
Delusion Severity Fell By 7.1 Points
That Test Ran Without A Control Group
A Randomised Version Began Recruiting In January 2025
It Plans 484 Participants Across Four Arms
Completion Is Expected In 2027
No Randomised Result For The Online Version Exists Yet
