Paranoid personality disorder is a mental condition in which a person has a long-term pattern of distrust and suspicion of others. The person does not have a full-blown psychotic disorder, such as schizophrenia.
Causes of paranoid personality disorder are unknown. The disorder appears to be more common in families with psychotic disorders, such as schizophrenia and delusional disorder. This suggests genes may be involved. Environmental factors may play a role as well.
The condition seems to be more common in men.
People with paranoid personality disorder are very suspicious of other people. As a result, they severely limit their social lives. They often feel that they are in danger and look for evidence to support their suspicions. They have trouble seeing that their distrustfulness is out of proportion to their environment.
Common symptoms include:
- Concern that other people have hidden motives
- Expectation that they will be exploited (used) by others
- Inability to work together with others
- Social isolation
Exams and Tests
Paranoid personality disorder is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms are.
Treatment is difficult because people with this condition are often very suspicious of doctors. If treatment is accepted, talk therapy and medicines can often be effective.
Outlook usually depends on whether the person is willing to accept help. Talk therapy and medicines can sometimes reduce paranoia and limit its impact on the person's daily functioning.
Complications may include:
- Extreme social isolation
- Problems with school or work
When to Contact a Medical Professional
See a health care provider or mental health professional if suspicions are interfering with your relationships or work.
Personality disorder - paranoid
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Elsevier; 2008:chap 39.
Triebwasser J, Chemerinski E, Roussos P, Siever LJ. Paranoid personality disorder, J Person Disord. 2013;27:795-805. PMID 22928850. www.ncbi.nlm.nih.gov/pubmed/22928850
Update Date 10/31/2014
Updated by: Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.