Paranoid personality disorder
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| Paranoid personality disorder | |
|---|---|
| Classification and external resources | |
| ICD-10 | F60.0 |
| ICD-9 | 301.0 |
| MedlinePlus | 000938 |
| MeSH | D010260 |
Paranoid personality disorder is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. Individuals with this personality disorder may be hypersensitive, easily feel slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence.[1] They tend to be guarded and suspicious and have quite constricted emotional lives. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience.[2][verification needed] People with this particular disorder may or may not have a tendency to bear grudges, suspiciousness, tendency to interpret others actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right.[3]
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[edit] Causes
A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. Psychosocial theories implicate projection of negative internal feelings and parental modeling.[4]
[edit] Diagnosis
[edit] WHO
The World Health Organization's ICD-10 lists paranoid personality disorder as (F60.0) Paranoid personality disorder.[5]
- It is characterized by at least three of the following:
- excessive sensitivity to setbacks and rebuffs;
- tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;
- suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;
- a combative and tenacious sense of personal rights out of keeping with the actual situation;
- recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;
- tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;
- preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.
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- Excludes:
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. It is also pointed out that for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.
[edit] APA
The American Psychiatric Association's DSM-IV-TR has similar criteria. They require in general the presence of lasting distrust and suspicion of others, interpreting their motives as malevolent, from an early adult age, occurring in a range of situations. 4 of 7 specific issues must be present, which include different types of suspicions or doubt (such as of being exploited, or that remarks have a subtle threatening meaning), in some cases regarding others in general or specifically friends or partners, and in some cases referring to a response of holding grudges or reacting angrily.[6]
[edit] Other
Various researchers and clinicians may propoose varieties and subsets or dimensions of personality related to the official diagnoses. Psychologist Theodore Millon has proposed five subtypes of paranoid personality:[7][8]
- fanatic paranoid - including narcissistic features
- malignant paranoid - including sadistic features
- obdurate paranoid - including compulsive features
- querulous paranoid - including negativistic (e.g. discontentment) features
- insular paranoid - including avoidant features
[edit] Differential diagnosis
Paranoid Personality Disorder can involve, in reponse to stress, very brief psychotic episodes (lasting minutes to hours). If long-lasting the disorder may develop into delusional disorder or schizophrenia. Individuals may also be at greater than average risk of experiencing major depressive disorder, agoraphobia, obsessive-compulsive disorder or alcohol and substance-related disorders. Criteria for other personality disorder diagnoses are commonly also met, such as:[9]
- schizoid personality disorder
- schizotypal personality disorder
- narcissistic personality disorder
- avoidant personality disorder
- borderline personality disorder
[edit] Treatment
Because of reduced levels of trust, there can be challenges in treating paranoid personality disorder. However, psychotherapy, antidepressants, antipsychotics and anti-anxiety medications can play a role when an individual is receptive to intervention.[10]
[edit] Epidemiology
Paranoid personality disorder occurs in about 0.5%-2.5% of the general population.[4][9] It is seen in 2%-10% of psychiatric outpatients. It occurs more commonly in males.[9]
A large long-term Norwegian twin study found paranoid personality disorder to be modestly heritable and to share a portion of its genetic and environmental risk factors with schizoid and schizotypal personality disorder.[11]
[edit] History
See the history of paranoia.
[edit] See also
[edit] References
- ^ Waldinger, 1997 Psychiatry for Medical Students
- ^ Meissner & Kuper, 2008
- ^ Fahy & MacManus. "Personality disorders" Medicine Volume 36, Issue 8, Pages 436-441, August 2008
- ^ a b "eMedicine - Personality Disorders : Article by David Bienenfeld". http://www.emedicine.com/med/topic3472.htm. Retrieved 2008-02-13.
- ^ Paranoid personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
- ^ DSM-IV-TR:Paranoid Personality Disorder: Diagnostic criteria BehaveNet, Retrieved January 17 2010
- ^ Millon, Theodore, Personality Disorders in Modern Life, 2004
- ^ Millon, Theodore - Personality Subtypes
- ^ a b c Internet Mental Health - paranoid personality disorder
- ^ ""Paranoid Personality Disorder" at Cleveland Clinic". http://www.clevelandclinic.org/health/health-info/docs/3700/3796.asp?index=9784. Retrieved 2008-02-13.
- ^ Kendler KS, Czajkowski N, Tambs K et al. (2006). "Dimensional representations of DSM-IV cluster A personality disorders in a population-based sample of Norwegian twins: a multivariate study". Psychological medicine 36 (11): 1583–91. doi:10.1017/S0033291706008609. PMID 16893481.
[edit] External links
- Paranoid personality disorder resources
- National Personality Disorder website for England
- Articles about Personality Disorders in Web4health web site
- Paranoid Personality Disorder (PPD) Quiz
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