Which statement by a client with schizophrenia best indicates delusional thinking?

Which statement by a client with schizophrenia best indicates delusional thinking?

• A. The voices are telling me to kill the next person I see.
• B. I feel anxious today.
• C. The nurse at night is trying to poison me with pills.
• D. I had a sandwich for lunch.

Answer: (C)

Delusional thinking is a fixed, false belief held with strong conviction despite clear evidence to the contrary. In schizophrenia, persecutory delusions are common, where a person believes others intend to harm them. The statement about the nurse at night trying to poison me with pills fits this pattern exactly: it is a belief that someone in authority plans to harm the person, and it persists even if there is no real basis for it. It’s not simply worry or a mood issue, and it’s not a perception or sensory experience. The other statements reflect different phenomena. Hearing voices is an auditory hallucination—perceiving something that isn’t real—rather than a belief. Feeling anxious is an emotional state, and having a sandwich for lunch is a neutral, everyday occurrence. Among these, the belief about being poisoned by pills best demonstrates delusional thinking.

Delusional thinking is a fixed, false belief held with strong conviction despite clear evidence to the contrary. In schizophrenia, persecutory delusions are common, where a person believes others intend to harm them. The statement about the nurse at night trying to poison me with pills fits this pattern exactly: it is a belief that someone in authority plans to harm the person, and it persists even if there is no real basis for it. It’s not simply worry or a mood issue, and it’s not a perception or sensory experience.

The other statements reflect different phenomena. Hearing voices is an auditory hallucination—perceiving something that isn’t real—rather than a belief. Feeling anxious is an emotional state, and having a sandwich for lunch is a neutral, everyday occurrence. Among these, the belief about being poisoned by pills best demonstrates delusional thinking.