Paranoid personality disorder

Alternative names 
Personality disorder - paranoid

Paranoid personality disorder is a psychiatric condition characaterized by extreme distrust and suspicion of others.

Causes, incidence, and risk factors
Personality disorders are chronic patterns of behavior that cause lasting problems with work and relationships. The cause of paranoid personality disorder is unknown, but it appears to be more common in families with psychotic disorders like schizophrenia and delusional disorder, which suggests a genetic influence.


People with paranoid personality disorder are highly suspicious of other people. They are usually unable to acknowledge their own negative feelings towards other people.

Other common symptoms include:

  • Concern that other people have hidden motives  
  • Expect to be exploited by others  
  • Inability to collaborate  
  • Poor self image  
  • Social isolation  
  • Detachment  
  • Hostility

Signs and tests

Personality disorders are diagnosed based on psychological evaluation and the history and severity of the symptoms.


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

Expectations (prognosis)

Therapy can limit the impact of the paranoia on the person’s daily functioning.


  • Extreme social isolation  
  • Potential for violence

Calling your health care provider

If suspicions are interfering with relationships or work, a health care provider or mental health professional should be consulted.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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