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Paranoid Personality Disorder
American Description 

Diagnostic Criteria
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 four (or more) of the following: 
suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her 
is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates 
is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her 
reads hidden demeaning or threatening meanings into benign remarks or events 
persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights 
perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack 
has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner 
Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition. 
Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Paranoid Personality Disorder (Premorbid)."

Associated Features
Odd/Eccentric/Suspicious Personality 
Dramatic/Erratic/Antisocial Personality 

Differential Diagnosis
Delusional Disorder, Persecutory Type; Schizophrenia, Paranoid Type; Mood Disorder With Psychotic Features; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; paranoid traits associated with the development of physical handicaps; Schizotypal Personality Disorder; Schizoid Personality Disorder; Borderline and Histrionic Personality Disorders; Avoidant Personality Disorder; Antisocial Personality Disorder; Narcissistic Personality Disorder. 

Internet Mental Health (www.mentalhealth.com) copyright © 1995-2000 by Phillip W. Long, M.D. 

 

 

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