Paranoid Personality Disorder – A Serious yet Neglected Condition

Paranoid Personality Disorder (PPD) belongs to a group of conditions called Cluster A or eccentric personality disorders. Persons with such personality disorders tend to exhibit unusual or abnormal behavior. These people possess unusual thinking. Persons with PPD are always suspicious of others and strongly believe that other people are constantly trying to harm them. Paranoia means illogical suspicion and mistrust towards other people.  It is a serious yet often neglected personality disorder.

American Psychiatric Association in DSM-5 states that 2.3% to 4.4 % of the US population suffers from PPD. It is mostly found in males.


The exact causes of PPD are not known. However several studies suggest that:

  • A person’s childhood experiences and past trauma can onset this condition. Childhood abuse, being a victim to bully or other such childhood factors can cause PPD.
  • Other social factors can also contribute to its cause, such as divorce, financial crisis, never marrying or other socio-economic factors
  • Family history of schizophrenia and delusional disorders.


DSM-5 lays that a PPD person has a pervasive pattern of suspiciousness, mistrust and hypersensitivity. Symptoms of PPD include:

  • There is no ground or logic for their suspicion that other people are trying to deceive them. They “think” that others are trying to exploit them.
  • They often criticize others but are hypersensitive towards other’s criticisms.
  • Will be jealous and strongly believe that their partners are being unfaithful.
  • Are unforgiving and hold grievances.
  • Due to lack of confidence, they are unable to build healthy relationship with family, friends and colleagues.
  • Without any substantiation, they believe that they will be betrayed.
  • They tend to find inner meaning in comments and communications from other people that are absolutely innocent and simple.
  • Always doubt the trustworthiness of others.
  • They constantly believe that people are ruining their character and reputation.
  • Do not realize that their behavior or attitude can be a cause of a problem.
  • They don’t open up to others on belief that others will use their personal information to manipulate them


A health care professional first discusses about symptoms and family history. The patient may also undergo physical examination. The health professional tries to assess the patient’s behavior by asking him about his response to an imaginary situation. Wrong diagnosis may mix up Paranoid Personality with Borderline Narcissism.


PPD persons generally do not recognize that they are suffering from such condition. So they do not seek treatment. Moreover, their treatment becomes a tough job due to their trust issues. They do not believe their psychotherapist. Patients with PPD are not likely to follow their treatment plan and may even question the therapist’s motives. Whenever a patient seeks medical assistance, psychotherapy is the preferred treatment. It includes improving their general coping ability and social interaction and communication skills.

Medications are not prescribed in PPD. However some anti-depressant, anti-anxiety or anti-psychotic drugs can be used if the person has severe symptoms.


There is no definite way to prevent Paranoid Personality Disorder. It may not be possible to prevent PPD, but treatment may allow those who are susceptible to it to find more productive ways to handle situations.