Paranoid Personality Disorder
What is "paranoid personality disorder"?
Paranoid personality disorder is when you see patients who have a pervasive suspiciousness and mistrust of others. And paranoid personality disorder, as with all personality disorders, has to start by at least early adulthood. And like with all personality disorders, paranoid personality disorder has to cause social and/or occupational dysfunction.
What are the signs of paranoid personality disorder?
This person will appear almost hyper-vigilant, like they are looking for data, you know, they are just waiting for you to do something that they can then interpret as you are bearing malintent towards them, so they also will read things into every little comment you say. Some small comments will be blown up into having some kind of malintent on your part. They are reluctant to share information with other people because again, they are convinced that that information will be used against them. Pathological jealousy is extremely common in these patients. They sue people left and right, you know, they are very litiginous, and despite the fact that they are rather cold and maybe perceived as somewhat arrogant, I would tell you that most people would characterize a paranoid individual as rather hostile and almost aggressive. Now what's important to understand, though, from the paranoid person's perspective -- they are merely defending themselves against these constant barrage of attacks that they think are coming at them all the time. So they wouldn't consider themselves as angry, hostile individuals, they are just trying to stick up for their own rights and make sure they don't get stepped on.
What are the causes of paranoid personality disorder?
We don't really know. I would say paranoid personality disorder is part of what we consider the Cluster A group of personality disorders. Combined with schizoid and schizotypal, these personality disorders are thought to be part of this so called schizophrenia spectrum. It might actually represent milder variants of schizophrenia, and they are more common in the first degree relatives of patients with schizophrenia. This may actually be one of those personality disorders that has a genetic component to it.
What are the dangers of paranoid personality disorder?
If you think about it, their social interactions with others are very impaired only because they don't trust anybody and they get mad at people all the time because they constantly think you're trying to mess with them. Sufferers are constantly accusing you and then getting angry, so they have great difficulty maintaining relationships with other people. I should add they aren't particularly interested in having relationships with other people either. Occupationally, there are very few jobs where you don't have to interact reasonably with other people, and since you're not being a very reasonable person your work performance can be dramatically affected.
What are the treatments for paranoid personality disorder?
There aren't any that uniformly or routinely work. Even if you can get a family member to bring sufferers in, they don't stick around. This means that we don't have much data on treatment. There doesn't appear to be anything that works routinely. Occasionally under great stress a paranoid person can actually get almost delusional. In other words, their paranoia can reach unreasonable and unrealistic heights. At that point, maybe low-dose anti-psychotics might be helpful for cooling off some of that, but they will still remain rather suspicious and distrustful.
