Paranoid personality disorder

For patient information click here

Paranoid personality disorder

ICD-10 | F60.0
ICD-9 | 301.0
MedlinePlus | 000938
MeSH | D010260

WikiDoc Resources for Paranoid personality disorder

Articles

Most recent articles on Paranoid personality disorder

Most cited articles on Paranoid personality disorder

Review articles on Paranoid personality disorder

Articles on Paranoid personality disorder in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Paranoid personality disorder

Images of Paranoid personality disorder

Photos of Paranoid personality disorder

Podcasts & MP3s on Paranoid personality disorder

Videos on Paranoid personality disorder

Evidence Based Medicine

Cochrane Collaboration on Paranoid personality disorder

Bandolier on Paranoid personality disorder

TRIP on Paranoid personality disorder

Clinical Trials

Ongoing Trials on Paranoid personality disorder at Clinical Trials.gov

Trial results on Paranoid personality disorder

Clinical Trials on Paranoid personality disorder at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Paranoid personality disorder

NICE Guidance on Paranoid personality disorder

NHS PRODIGY Guidance

FDA on Paranoid personality disorder

CDC on Paranoid personality disorder

Books

Books on Paranoid personality disorder

News

Paranoid personality disorder in the news

Be alerted to news on Paranoid personality disorder

News trends on Paranoid personality disorder

Commentary

Blogs on Paranoid personality disorder

Definitions

Definitions of Paranoid personality disorder

Patient Resources / Community

Patient resources on Paranoid personality disorder

Discussion groups on Paranoid personality disorder

Patient Handouts on Paranoid personality disorder

Directions to Hospitals Treating Paranoid personality disorder

Risk calculators and risk factors for Paranoid personality disorder

Healthcare Provider Resources

Symptoms of Paranoid personality disorder

Causes & Risk Factors for Paranoid personality disorder

Diagnostic studies for Paranoid personality disorder

Treatment of Paranoid personality disorder

Continuing Medical Education (CME)

CME Programs on Paranoid personality disorder

International

Paranoid personality disorder en Espanol

Paranoid personality disorder en Francais

Business

Paranoid personality disorder in the Marketplace

Patents on Paranoid personality disorder

Experimental / Informatics

List of terms related to Paranoid personality disorder

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Jesus Rosario Hernandez, M.D. [2]

Synonyms and keywords: Overly suspicious

## Overview

[edit | edit source]

Paranoid personality disorder is a psychiatric diagnosis characterized by paranoia characterized by a pervasive and long-standing suspiciousness and generalized mistrust of others. For a person's personality to be considered a personality disorder, an enduring pattern of characteristic maladaptive behaviors, thinking and personality traits must be present from the onset of adolescence or early adulthood. Additionally, these behaviors, traits and thinking must be present to the extent that they cause significant difficulties in relationships, employment and other facets of functioning. Those with paranoid personality disorder are hypersensitive, are easily slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions to validate their prejudicial ideas or biases. They tend to be guarded and suspicious and have quite constricted emotional lives. Their incapacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience.[1]

## Differential Diagnosis

[edit | edit source]

* Bipolar disorder
* Delusional disorder
* Depressive disorder
* Medical condition that affects central nervous system
* Substance use disorder
* Schizotypal personality disorder
* Schizophrenia[2]

## Epidemiology and Demographics

[edit | edit source]

### Prevalence

[edit | edit source]

The prevalence of paranoid personality disorder is 2,300 to 4,400 per 100,000 (2.3% to 4.4%) of the overall population.[2]

## Risk Factors

[edit | edit source]

* Schizophrenia
* Delusional disorder[2]

## Natural History, Complications and Prognosis

[edit | edit source]

Poor prognostic factors include:

* Solitariness
* Poor peer relationships
* Social anxiety
* Underachievement at school
* Hypersensitivity
* Peculiar thoughts and language
* Idiosyncratic fantasies[2]

## Diagnosis

[edit | edit source]

### Diagnosis Criteria

[edit | edit source]

#### DSM-V Diagnostic Criteria for Paranoid Personality Disorder[2]

[edit | edit source]

“  |

* A. A pervasive distrust and suspiciousness of others such that their nfiotives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

* B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

Note: If criteria are met prior to the onset of schizophrenia, add “premorbid,” i.e., “paranoid personality disorder (premorbid).”

| ”

|
|

#### Descriptive Diagnosis per American DSM-IV-TR

[edit | edit source]

Paranoid personality disorder is listed in the DSM-IV-TR as 301.00 Paranoid Personality Disorder.

According to the DSM-IV-TR, this disorder is characterized by a pervasive distrust and suspicion of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

* Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
* Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
* Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
* Reads benign remarks or events as threatening or demeaning.
* Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
* Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
* Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

The traits, behaviors and characteristics

* Do not occur exclusively during the course of a mood disorder accompanied by psychotic features nor other psychotic disorders.
* Are not due to the direct physiological effects of a general medical condition.

#### European Description per ICD-10

[edit | edit source]

The ICD-10 lists paranoid personality disorder as F60.0 Paranoid Personality Disorder.

This personality disorder is characterized by at least 3 of the following: (a) excessive sensitiveness to setbacks and rebuffs; (b) tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights; (c) suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; (d) a combative and tenacious sense of personal rights out of keeping with the actual situation; (e) recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner; (f) tendency to experience excessive self-importance, manifest in a persistent self-referential attitude; (g) preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.

Includes:

* expansive paranoid, fanatic, querulant and sensitive paranoid personality (disorder)

Excludes:

* delusional disorder
* schizophrenia

Personality Disorders

A personality disorder is a severe disturbance in the characterological constitution and behavioral tendencies of the individual, usually involving several areas of the personality, and nearly always associated with considerable personal and social disruption. Personality disorder tends to appear in late childhood or adolescence and continues to be manifest into adulthood. It is therefore unlikely that the diagnosis of personality disorder will be appropriate before the age of 16 or 17 years. General diagnostic guidelines applying to all personality disorders are presented below; supplementary descriptions are provided with each of the subtypes. Diagnostic Guidelines

Conditions not directly attributable to gross brain damage or disease, or to another psychiatric disorder, meeting the following criteria:

“  |

(a) markedly dysharmonious attitudes and behavior, involving usually several areas of functioning, e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others; (b) the abnormal behavior pattern is enduring, of long standing, and not limited to episodes of mental illness; (c) the abnormal behavior pattern is pervasive and clearly maladaptive to a broad range of personal and social situations; (d) the above manifestations always appear during childhood or adolescence and continue into adulthood; (e) the disorder leads to considerable personal distress but this may only become apparent late in its course; (f) the disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

| ”

|
|

#### Cultural Sensitivities

[edit | edit source]

The WHO, in the ICD-10, points out for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.

## Treatment

[edit | edit source]

Because of reduced levels of trust, there can be challenges in treating paranoid personality disorder. However, psychotherapy, antidepressants, and anti-anxiety medications can play a role when an individual is receptive to intervention.[3]

## References

[edit | edit source]

1. ↑ Meissner & Kuper, 2008.
2. ↑ 2.0 2.1 2.2 2.3 2.4 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
3. ↑ ""Paranoid Personality Disorder" at Cleveland Clinic". Retrieved 2008-02-13.

Template:WikiDoc Sources