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Paranoid personality disorder
ICD-10 F60.0
ICD-9 301.0
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Paranoid personality disorder is a cluster A personality disorder or 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 is not be confused with paranoid schizophrenia, which is another totally different type of mental disorder that the patient has constant feelings of being watched, followed, or persecuted.

Diagnostic criteria (DSM-IV-TR)

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 3 (or more) of the following:
  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Being preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Being 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. Have 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 it is not due to the direct physiological effects of a general medical condition.


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
  • Paranoid PD: Psychodynamic perspective
  • Paranoid PD: Cognitive perspective
  • Paranoid PD: Interpersonal perspective
Main article: Paranoid PD: Epidemiology
Main article: Paranoid PD: Risk factors
  • Paranoid PD: Known evidence of risk factors
  • Paranoid PD: Theories of possible risk factors
Main article: Paranoid PD: Etiology
  • Paranoid PD: Known evidence of causes
  • Paranoid PD: Theories of possible causes
Main article: Paranoid PD: Diagnosis & evaluation
  • Paranoid PD: Psychological tests
  • Paranoid PD: Assessment isssues
  • Paranoid PD: Evaluation protocols
Main article: Paranoid PD: Treatment
  • outcome studies
  • Paranoid PD: Treatment protocols
  • Paranoid PD: Treatment considerations
  • Paranoid PD: Evidenced based treatment
  • Paranoid PD: Theory based treatment
  • Paranoid PD: Team working considerations
  • Paranoid PD: Followup
Main article: Paranoid PD: For people with this difficulty
  • Paranoid PD: Service user: How to get help
  • Paranoid PD: Service user: Self help materials
  • Paranoid PD: Service user: Useful reading
  • Paranoid PD: Service user: Useful websites
  • Paranoid PD: Service user: User feedback on treatment of this condition
Main article: Paranoid PD: For their carers

Paranoid PD: Academic support materials

  • Paranoid PD: Academic: Lecture slides
  • Paranoid PD: Academic: Lecture notes
  • Paranoid PD: Academic: Lecture handouts
  • Paranoid PD: Academic: Multimedia materials
  • Paranoid PD: Academic: Other academic support materials
  • Paranoid PD: Academic: Anonymous fictional case studies for training
  • Paranoid PD: Anonymous fictional case studies for training

See also

References & Bibliography

  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



Additional material



External links

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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