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Paranoid personality disorder
ICD-10 F60.0
ICD-9 301.0
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Paranoid personality disorder is a psychiatric diagnosis characterized by paranoia characterized by a pervasive and long-standing suspiciousness and generalized mistrust of others. (DSM-IV) 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. - Meissner & Kuper, 2008.

Differential diagnosis:

  • Because of the surface similarities of the paranoia involved, it is important that the Paranoid Personality Disorder not be confused with paranoid schizophrenia, another totally different type of mental disorder where the patient has constant feelings of being watched, followed or persecuted.

Diagnostic criteria (DSM-IV-TR)[edit | edit source]

The DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines paranoid personality disorder as a cluster A personality disorder (along with schizoid personality disorder (301.20) and schizotypal personality disorder (301.22)):

  • 301.00 Paranoid Personality Disorder
A. A pervasive distrust and suspiciousness 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:
  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 mood disorder with psychotic features, or another psychotic disorder and is not due to the direct physiological effects of a general medical condition.

Mnemonic[edit | edit source]

A mnemonic that can be used to remember the criteria for paranoid personality disorder is SUSPECT[1][2]:

  • S - spouse is cheating suspected
  • U - unforgiving - bears grudges
  • S - suspicious (of others)
  • P - perceives attacks (and reacts quickly)
  • E - enemy in everyone - suspects associates, friends
  • C - confiding in others feared
  • T - threats seen in benign events
Main article: Paranoid PD: History of the disorder

Main article: Paranoid PD: Theoretical approaches
Main article: Paranoid PD: Biological perspective
Main article: Paranoid PD: Evolutionary perspective
Main article: Paranoid PD: Epidemiology
Main article: Paranoid PD: Risk factors
Main article: Paranoid PD: Etiology
Main article: Paranoid PD: Diagnosis & evaluation
Main article: Paranoid PD: Treatment
Main article: Paranoid PD: For people with this difficulty
Main article: Paranoid PD: For their carers

Instructions_for_archiving_academic_and_professional_materials Paranoid PD: Academic support materials

Paranoid PD: Anonymous fictional case studies for training

See also[edit | edit source]

References & Bibliography[edit | edit source]

  1. Pinkofsky HB. Mnemonics for DSM-IV personality disorders. Psychiatr Serv. 1997 Sep;48(9):1197-8. PMID 9285984.
  2. Personality Disorders. URL: Accessed May 3, 2006.

Key texts[edit | edit source]

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Additional material[edit | edit source]

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External links[edit | edit source]

Personality Disorder
Personality disorder | Psychopathy 

DSM-IV Personality Disorders

Cluster A (Odd) - Schizotypal, Schizoid, Paranoid
Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic
Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant
Personality disorder not otherwise specified
Assessing Personality Disorder
MCMI | MMPI | Functional assessment
Treating Personality Disorder
DBT | CBT | Psychotherapy |Mindfulness-based Cognitive Therapy
Prominent workers in Personality Disorder
Millon | Linehan

DSM-IV Personality Disorders edit

Cluster A (Odd) - Schizotypal, Schizoid, Paranoid
Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic
Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant
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