Delusions

The association between delusions and violence has been reviewed by Mullen et a/.(7!> Most investigations have been of acting on delusions; for instance, of 20 people who had pushed strangers on to New York's subway tracks, 10 were influenced by delusions or hallucinations. (72) Taylor(73> found that 47 per cent of a cohort of psychotic prisoners described psychotic motivation, usually delusions, for their offences; passivity, religious, and paranormal delusions were particularly noted.

Buchanan et a/.(74> supplemented the patient's account with that of an informant; they found that 50 per cent of their sample reported acting on delusions in the previous week, though rarely with violence. Acting on delusions was more likely in those patients who sought further evidence for their beliefs, who reduced the conviction of their belief when challenged, and who registered accompanying affective symptoms. Virtually all types of delusions have, in various studies, been said to indicate a potential for violence, yet most schizophrenic subjects with delusions do not act on them.

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