Persecutory Delusion — MRCPsych Paper B MCQ

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EasySchizophrenia & PsychosisPersecutory DelusionMRCPsych Paper B

A 45-year-old man with schizophrenia is convinced that his GP is deliberately trying to harm him by adding poison to his prescribed tablets. There is no supporting evidence, and he maintains this belief despite clear evidence to the contrary. The belief is not shared by members of his cultural or religious group. Which type of psychopathology is this?

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Correct answer: E — Persecutory delusion

The correct answer is E, persecutory delusion. The belief is incorrigible despite contrary evidence, is outside the person’s sociocultural context, and has persecutory content because he believes another person intends to poison and harm him. An overvalued idea is an emotionally charged, dominant belief that remains more understandable in relation to the person’s values or circumstances. An obsession is an intrusive, recurrent thought recognised as originating in the person’s own mind and usually experienced as unwanted or ego-dystonic. An illusion is a misinterpretation of a real sensory stimulus. Depersonalisation is an altered experience of the self, such as feeling detached from one’s thoughts, body or actions.

Reference: Royal College of Psychiatrists, Present State Examination 2025 booklet, section on delusions of reference and persecution, 2025. https://www.rcpsych.ac.uk/docs/default-source/events/2025-events/present-state-examination/events---present-state-examination-2025---booklet.pdf?sfvrsn=a15a7182_3