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What research questions would you like answered about paranoia?

We’re looking for people with lived experience of paranoia, as well as their families, NHS workers and researchers, to share their thoughts and help shape the future of paranoia research

Thomas Kabir

Paranoia – now that’s a loaded word!

In its most basic form ‘paranoia’ is usually taken to mean that someone is overly suspicious, or that they even feel threats that are exaggerated or simply not there.

It’s a difficult concept, as the world clearly is a dangerous place. Bad things do happen to people. Context is always extremely important – and recent world events such as the pandemic have not made things any easier.

A growing problem

It is probably the case that some form of ‘paranoia’ (or at least a heightened feeling of threat) is rather common. A 2009 article in The Guardian has the strapline ‘Once it affected 1% of the population. Now more than a quarter of us suffer from paranoia, leading expert Daniel Freeman tells Sabine Durrant’.

In mental health services paranoia is most often treated in the context of another issue, such as psychosis. Indeed, ‘paranoid personality disorder’ seems to be one of the only ‘official’ diagnoses with the actual word ‘paranoid’ in it.

Even the word ‘paranoia’ feels very stigmatising. It is all too easy that people who are labelled as being paranoid lose their right to be believed.  

Impacting ‘almost every aspect’ of life

The effects of paranoia can be severe. It can prevent people from forming and sustaining relationships and friendships. It can make having a job difficult – or impossible at times. Paranoia can affect almost every aspect of life.

In addition to this, people with paranoia can face the stigma of having much of what they say questioned; the basis of this being ‘well, this sounds paranoid…’.

Until fairly recently I would say that paranoia was not well understood or treated. One of the most well-known researchers of paranoia is the previously mentioned Daniel Freeman at Oxford University.

Treatments for paranoia

A few years ago McPin was asked by Daniel to help with the Feeling Safe study. Feeling Safe is a form of CBT-based talking therapy created for people with a form of paranoia called ‘paranoid persecutory delusions’, which is when people feel that others may want to harm them.

The results were impressive. Feeling Safe is currently one of the most effective talking therapies for paranoid persecutory delusions. I still regularly get emails from people from all over the world asking when the therapy might be available more generally.

There are some training programmes now running in Oxford, but the capacity to offer this in the NHS in general is simply not there at the moment.

More recently we have been using virtual reality to see if it can help people with paranoia in the gameChange study, the results of which were released in April.

A long way to go

Despite the advances in the treatment and understanding of paranoia there is still so much work to be done. Unfortunately it is still the case that treatments are not widely available due to the typically slow adoption of research within practice.

We don’t fully understand the impact that paranoia has on people, and the number of approaches that we have to offer them are still limited.

This all means that we need new ideas – and we need to prioritise what to research.  

Help shape the future of paranoia research

A new study is being undertaken by David Sher at Oxford University to get people’s ideas for future research. It’s called the SPPaRO study (Setting Priorities for Paranoia Research).

The study focuses on the ‘paranoid persecutory delusions’ mentioned above, beginning with a survey to find out what people with experience of paranoia – either directly or indirectly – want prioritising.

The study is currently recruiting people who self-identify as having lived experience of severe paranoia (either currently or in the past), as well as their family members, and NHS mental health professionals and researchers.

Please consider taking part in the study. You can find out more and complete the survey here.

Find out more and share your priorities for paranoia research


Thomas Kabir is Head of Public Involvement at McPin.