Subjective experience and meaning of delusions in psychosis: a systematic review and qualitative evidence synthesis.
Lancet Psychiatry May 1, 2022 R. Ritunnano, Joshua J. Kleinman, Danniella Whyte Oshodi et al.
Delusions in psychosis are best understood as highly individual and complex phenomena arising from a dynamic interplay of biological, personal, social, and cultural processes. A systematic review and qualitative synthesis of 24 studies representing 373 help-seeking individuals with psychosis identified three key themes: a radical shift in the lived world dominated by intense emotions; a process of doubting, losing, and rediscovering oneself within delusional realities; and a search for meaning, belonging, and coherence beyond mere dysfunction. The findings propose an Emergence Model of Delusion, suggesting that effective clinical care should account for the subjective experience and meaning of delusions, which may also address power imbalances and epistemic injustices in mental health.