Question:
Why is it that many people suffering from schizophrenia seem to have delusions and paranoia about the FBI, Government conspiracies, etc.? Is there something about law enforcement that scares all of us beneath the surface?

Wayland S.
New Haven, Connecticut

Answered by Irving I. Gottesman, Ph.D.:
Delusions occur across a wide variety of psychiatric (mood disorders, abuse of alcohol, amphetamine, cocaine, etc.) and non-psychiatric ( subdural hematoma, hypoglycemia, vitamin deficiencies, etc.) conditions and are not specific to schizophrenia. An excellent overview is provided by Dr. Theo C. Manschreck in Kaplan & Sadock's Comprehensive Textbook of Psychiatry (7th edition). You ask about one particular subtype of delusion, that of persecution, which is observed across cultures in individuals who develop paranoid schizophrenia. The content of the delusions, that is, FBI or CIA, Buddha or Christ, ghosts or Satan, are products of the culture in which one is reared. It is an error for a diagnostician to try to judge what is or is not a delusion in persons from unfamiliar cultures and religions. In patients with schizophrenia, delusions are taken as the proxy for thought disorder which cannot be observed directly. Delusional disorder, formerly known as paranoia, is probably a different disorder from schizophrenia in that, unlike the latter, it is very rarely familial.