Paranoid Personality Disorder
- Paranoid personality disorder is a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
- Consequently, patients avoid intimate relationships, bear grudges, and expect to be exploited by others.
- Paranoid personality disorder is one of the cluster A personality disorders.
- Certain DSM-IV personality disorders (paranoid, schizoid, histrionic, and dependent as well as the residual category of PDNOS) are now diagnosed in the DSM-5 as personality disorder—trait specified (PD-TS), which is represented by the following:
- Significant impairment in personality functioning
- Pathologic personality traits
- Predominant age: first manifests during childhood or adolescence
- Predominant sex: male > female
- Increased in families with delusional disorder (persecutory type) and chronic schizophrenia
- Thought to be underdiagnosed because these patients are less likely to seek treatment
- 0.5–2.5% of the general population
- 2–10% of psychiatric outpatients
- 10–30% of psychiatric inpatients
Etiology and Pathophysiology
Paranoid sense of mistrust can result from childhood abuse/neglect and/or genetic predisposition to paranoia. Specific causes are unknown.
Genetic predisposition may play a role (see “Incidence”).
- Family history of paranoid personality disorder
- Childhood abuse/neglect
Commonly Associated Conditions
- May develop major depressive disorder
- May be at increased risk for obsessive-compulsive disorder and agoraphobia
- At risk for alcohol and/or other substance abuse/dependence
- Most common co-occurring personality disorders are schizotypal, schizoid, narcissistic, avoidant, and borderline.
- Increased rate of suicide and self-injurious behavior when comorbid with borderline personality disorder (1)[C]
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Domino, Frank J., et al., editors. "Paranoid Personality Disorder." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688781/all/Paranoid_Personality_Disorder.
Paranoid Personality Disorder. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688781/all/Paranoid_Personality_Disorder. Accessed June 5, 2023.
Paranoid Personality Disorder. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688781/all/Paranoid_Personality_Disorder
Paranoid Personality Disorder [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 05]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688781/all/Paranoid_Personality_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Paranoid Personality Disorder ID - 1688781 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688781/all/Paranoid_Personality_Disorder PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -