Delusions of Sin and Guilt in Schizophrenia Patients - Psychiatry

Have you heard of patients with schizophrenia experiencing delusions of sin or guilt?

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Patients with schizophrenia who experience delusions of sin or guilt firmly believe that they have done something wrong and are being punished or should be punished.
These delusions may relate to a real event or may be entirely imagined; however, even if a real event exists, the punishment the patient envisions far exceeds the severity of the wrongdoing (for example, a person who forgets to help their father mow the lawn may believe they should be punished by being locked in a closet for life).

This issue first arose three years ago when I was working at a gas station.
We had a task called "testing barrels," which involved taking fuel out and pouring it back into the tank.
I was responsible for pouring it back into the tank.
There were four barrels of fuel on the cart, and I initially judged them to be diesel.
I poured all four barrels, each containing 10 liters, into the diesel tank.
Later, I noticed that two of the barrels had a yellowish color (yellow indicates gasoline, while clear and light yellow indicate diesel), which made me suspect that I might have poured in two barrels of 95 gasoline.
I am unsure if therapists know that gasoline and diesel cannot be mixed, as adding gasoline to a diesel vehicle can severely damage the engine.
The day after the incident, I went to confirm that I had not made a mistake, and I felt reassured for two years.

In April, I recalled the incident and realized that there was still a possibility I had made a mistake (not that I was overthinking it; it was genuinely possible).
I recognized that my previous confirmation was somewhat dismissive.
The moment I remembered the possibility of having made an error, I felt an immense pressure inside me, which did not alleviate even after ten months.
To put it simply, there was an overwhelming energy compelling me to make the largest possible amends for this incident (which I am still unsure about), such as compensating the vehicle owner.
If I did not make amends, this energy would continue to deplete me, to the point where I could not live or work normally, rendering me incapable of doing anything.

As a result, I have truly been drained to the point of reduced cognitive ability, diminished understanding, and significant physical decline, making it impossible for me to care for myself.
At the time of the mistake, I felt it was just a typical work oversight, not intentional.
However, two years later, in April, when I thought about the incident, my body continuously imposed self-punishment on me, which was not something I actively desired or requested.
My body has been in a constant state of energy depletion, leading to immense suffering over the past ten months, to the extent that I cannot even walk or lift heavy objects, leaving me unable to do anything.
This self-punishment and energy depletion have persisted every minute without pause.

To put it in perspective, you might not believe it, but the energy I have lost feels equivalent to running ten laps around a track in one second.
I can only lie in bed each day, and the discomfort from this constant energy depletion has caused me great pain and despair.
I wonder why recalling a potential oversight from my past work would result in such hellish suffering.
I have always believed that even after 20 or 30 years, if the vehicle owner’s car were to have an issue, they would surely find a way to locate me.
Furthermore, as long as I have thoughts of wanting to resolve this overwhelming guilt, this powerful sense of guilt will further deplete my energy, leaving me even weaker and more uncomfortable.
Therefore, whenever I visit a doctor, it only makes me feel more exhausted and uncomfortable, as if it is affirming that this guilt is justified and questioning why I would want to resolve it.
Most doctors I have seen have suggested it might be obsessive-compulsive disorder, even though I have researched this type of delusion online.

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Hanhan, 20~29 year old female. Ask Date: 2021/02/27