Evidence map›Paper›PMID 40574663›Full record

Trial reportSchizophrenia bulletin2026

Learning How to Improve the Treatment of Persecutory Delusions: Using a Principal Trajectories Analysis to Examine Differential Effects of Two Psychological Interventions (Feeling Safe, Befriending) in Distinct Groups of Patients.

Lucy Jenner, Mollie Payne, Felicity Waite, Helen Beckwith, Rowan Diamond, Louise Isham, Nicola Collett, Richard Emsley, Daniel Freeman

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lucy JennerInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AB, United Kingdom.ORCID 0000-0002-4245-433X
Mollie PayneDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom.
Felicity WaiteDepartment of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, United Kingdom.
Helen BeckwithDepartment of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, United Kingdom.
Rowan DiamondDepartment of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, United Kingdom.
Louise IshamDepartment of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, United Kingdom.
Nicola CollettAneurin Bevan University Health Board, Wales, NP18 3XQ, United Kingdom.
Richard EmsleyDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom.ORCID 0000-0002-1218-675X
Daniel FreemanDepartment of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, United Kingdom.ORCID 0000-0002-2541-2197

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA theory-driven cognitive therapy (Feeling Safe) has produced much better outcomes for patients with persecutory delusions. There are four distinct response classes: very high delusion conviction with large improvement, very high delusion conviction with no response, high delusion conviction with large improvement, and high delusion conviction with modest improvement. Our objective was to apply principal trajectories analysis, a novel statistical method, to original trial data to estimate whether these groups may have responded differently to a different intervention: befriending.

designOne hundred and thirty patients with persistent persecutory delusions were randomised to six months of Feeling Safe or befriending. Baseline assessments were used to assign patients allocated to befriending (who did not receive Feeling Safe) into the four Feeling Safe response classes. The treatment effect, including on potential mediators, was then estimated for these classes.

resultsPatients in two treatment response classes (Very high conviction/large improvement, High conviction/large improvement) benefited more from Feeling Safe, patients in one group (Very high conviction/no improvement) benefited more from befriending, and patients in the remaining group (High conviction/moderate improvement) benefited equally from the interventions. Mechanism differences were detected when Feeling Safe was superior to befriending, but not when befriending was superior.

conclusionsThere may be patients with psychosis who benefit more from one type of therapy than another, likely due to different change mechanisms. The application of principal trajectories has generated testable hypotheses and a potential step toward personalised treatment. We recommend an investigation of whether sequential provision of the treatment types could enhance patient outcomes. Keywords: persecutory, delusions, outcome trajectories, psychosis, cognitive therapy.

Indexed as

Cognitive Behavioral TherapyDelusionsOutcome Assessment, Health CarePsychotic DisordersSchizophreniaAdultFemaleHumansMaleMiddle Agedcognitive therapydelusionsoutcome trajectoriespersecutorypsychosis

Identifiers

PMID40574663
PMCPMC12809788

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.