Paranoia

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(Redirected from Paranoid reaction)

Mental condition involving intense, unwarranted distrust or suspicion


Paranoia
Synonyms Paranoid (adjective)
Pronounce
Specialty N/A
Symptoms Distrust, Suspicion, False accusations, Social withdrawal
Complications Impaired relationships, occupational dysfunction, social isolation
Onset Typically early adulthood
Duration Variable; chronic in some personality disorders
Types Paranoid personality disorder, Delusional disorder, Paranoid schizophrenia
Causes Multifactorial – genetic, psychological, environmental
Risks Family history, trauma, social isolation, substance use
Diagnosis Clinical assessment, psychiatric evaluation
Differential diagnosis Schizophrenia, Schizoaffective disorder, Borderline personality disorder, Obsessive–compulsive disorder
Prevention Early intervention in high-risk individuals
Treatment Psychotherapy, Cognitive behavioral therapy, medication
Medication Antipsychotics, Anxiolytics, Antidepressants (if comorbid depression)
Prognosis Variable; better with early treatment and insight
Frequency Unknown; present in multiple psychiatric conditions
Deaths Indirect (e.g., suicide, accidents due to delusions)


Paranoia is a mental state marked by pervasive and unwarranted distrust or suspicion of others, often involving the belief that others are out to deceive, harm, or exploit the individual. While occasional suspicious thoughts can be normal, especially in situations of uncertainty or fear, persistent or extreme forms of paranoia may indicate an underlying mental health condition.

Characteristics[edit | edit source]

Paranoia typically involves:

  • Persistent, irrational mistrust of others
  • Interpretation of innocent remarks or events as hostile
  • Belief in hidden motives or conspiracies
  • Feelings of being watched, followed, or plotted against
  • Reluctance to confide in others due to fear of betrayal

The condition can severely impair social and occupational functioning, especially when the paranoid thoughts evolve into fixed delusions.

Subtypes and Presentations[edit | edit source]

Paranoia may manifest in various forms or themes, including:

  • Persecutory paranoia: The belief that one is being harassed, spied on, or harmed.
  • Erotomanic paranoia: The false belief that another person, often of higher status, is in love with the individual.
  • Litigious paranoia: A pattern of excessive legal complaints and belief in systematic injustice.
  • Exalted or grandiose paranoia: Inflated self-importance and belief in special powers or roles.

Associated Conditions[edit | edit source]

Paranoia is not a diagnosis on its own but occurs in several psychiatric disorders, such as:

Causes and Risk Factors[edit | edit source]

Paranoia is believed to arise from a combination of genetic, neurobiological, psychological, and environmental factors.

Common contributing elements include:

  • Family history of mental illness
  • Exposure to childhood trauma or neglect
  • Chronic social isolation
  • Substance use, particularly cannabis, amphetamines, or cocaine
  • Brain abnormalities affecting the limbic system and prefrontal cortex

Diagnosis[edit | edit source]

Diagnosis is made through:

  • Comprehensive psychiatric evaluation
  • Interviews and standardized assessments
  • Rule-out of other mental or medical conditions
  • Monitoring over time for persistence of symptoms

Paranoia must be distinguished from culturally appropriate beliefs or justified concerns.

Treatment[edit | edit source]

Treatment depends on the severity and underlying cause.

Psychotherapy[edit | edit source]

Medications[edit | edit source]

Lifestyle and Social Support[edit | edit source]

  • Encouraging social engagement
  • Educating family members
  • Stress reduction and relaxation techniques

Prognosis[edit | edit source]

The outcome varies widely depending on the cause and individual insight. People with paranoid personality disorder may function relatively well but struggle with interpersonal relationships. Paranoia associated with psychotic disorders may require long-term treatment.

Early intervention and strong therapeutic alliances improve prognosis.

See also[edit | edit source]

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Contributors: Prab R. Tumpati, MD