Paranoid Personality Disorder

People with paranoid personality disorder are distrustful and suspicious and anticipate harm and betrayal.

Epidemiology
Paranoid personality disorder has a lifetime prevalence of 0.5% to 2.5% of the general population. Relatives of chronic schizophrenics and patients with persecutory delusional disorders show an increased prevalence of paranoid personality disorder.

Etiology
Environmental precursors are unclear. Family studies suggest a link to delusional disorder (paranoid type).

There appears to be a small increase in prevalence among relatives of schizophrenics.

Clinical Manifestations
History and Mental Status Examination
People with paranoid personality disorder are distrustful, suspicious and see the world as malevolent.

They anticipate harm, betrayal, and deception. Not surprisingly, they are not forthcoming about themselves. They require emotional distance.

Differential Diagnosis
The key distinction is to separate paranoia associated with psychotic disorders from paranoid personality disorder, especially because paranoia associated with psychotic disorders is generally responsive to antipsychotic medications.