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Paranoid personality disorder

Paranoid personality disorder is a mental health condition in which a person has a long-term pattern of distrust and suspicion of others, but does not have a full-blown psychotic disorder such as schizophrenia .

Alternative Names

Personality disorder - paranoid

Causes, incidence, and risk factors

Cause of paranoid personality disorder is unknown. The disorder appears to be more common in families with psychotic disorders such as schizophrenia and delusional disorder. This suggests genes may be involved. Environmental factors may play a role as well.

The condition appears to be more common in men.

Symptoms

Persons with paranoid personality disorder are very suspicious of other people. As a result, they severely limit their social lives. They often feel that they are in danger and look for evidence to support their suspicions. They have trouble seeing that their distrustfulness is out of proportion to their environment.

Common symptoms include:

  • Concern that other people have hidden motives
  • Expectation that they will be exploited (used) by others
  • Inability to work together with others
  • Social isolation
  • Detachment
  • Hostility

Signs and tests

Paranoid personality disorder is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.

Treatment

Treatment is difficult because people with this condition are often very suspicious of doctors. If treatment is accepted, talk therapy and medications can often be effective.

Expectations (prognosis)

Outlook usually depends on whether the person is willing to accept help. Talk therapy and medications can sometimes reduce paranoia and limit its impact on the person's daily functioning.

Complications

  • Extreme social isolation
  • Problems with school or work

Calling your health care provider

See a health care provider or mental health professional if suspicions are interfering with your relationships or work.

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Elsevier; 2008:chap 39.

Updated: 11/10/2012

David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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