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Conspiracy beliefs (also known as conspiracy theories) become more prominent at times of heightened uncertainty and inconsistent or conflicting explanations provided by the authorities for events like terrorist attacks or pandemics, such as COVID-19. This article aims to examine the relevance of conspiracy beliefs for psychiatry in the context of the dynamics of trust and mistrust. Conspiracy beliefs may be situated on a spectrum of mistrust-related phenomena, which extends from healthy scepticism to persecutory delusions. They can be c