Paranoid personality disorder is a mental health condition marked by suspicion and distrust that has no correlation with any situation or experience either past or present. They are suspicious of the motives of others and prone to the development of overvalued ideas. They may be excessively self reliant and self isolatory and often quarrel with others. There is no psychosis. however, some go on to develop a psychiatric illness like schizophrenia.
- Erotomanic type: In this the predominant theme is that a person, usually of a higher status, is in love with the patient.
- Grandiose type: The predominant theme is one of inflated worth, power or knowledge or a special relationship to God or a famous person.
- Jealous type: The predominant theme is that the sexual partner is unfaithful.
- Persecutory type: The predominant theme is that someone is against the individual and he is being mistreated by him.
- Somatic type: The predominant scheme is that the person has some physical disease or defect.
- Unspecified type: All that does not clearly fit in any of the above.
The primary symptoms are a delusion or delusional system that is not related to any organic disorder or drug abuse. The patients often feel that they are in danger, and look for evidence to support their suspicions. The patient’s are not able to understand that their distrustis out of proportion. The delusional ideas gradually evolve and become the primary concern of the patient’s life. The patient may start from a minor frustrating experience to which they keep adding points to justify the conspiracy against them.
A sense of self importance may develop as the patient begins to see themselves as fighting for a good cause. The second major theme in this disorder is of sexual infidelity and jealousy. He/she is convinced that the spouse is having extramarital affairs and sees clues everywhere, in misplaced household articles or pieces of overheard conversations or gestures.
Despite these widespread delusional beliefs, these patients are able to carry on with their normal social activities and work. Chronic symptoms are often seen in long term alcoholics. Gradually, the condition could worsen and can create disturbance in the patient’s work or the patient may resort to complete isolation.
The exact cause for paranoid personality disorder is not known. The disease is more common in families who have a history of psychiatric illnesses such as schizophrenia, suggesting that genetic factors may be involved in the cause of the disease. Environmental factors could also be among the causative factors as well as a history of abuse, especially in the early years of life.
Haloperidol or pimozide are the most common drugs used in the treatment of paranoid personality disorders which are started initially in low doses. These drugs cause less sedation and allows the person to function without being severely impaired. Psychotherapy is essential despite the use of medication. Both the patient and family members require counseling to cope with the disease and manage daily life in the best possible way.