Paranoia

Paranoid personality disorder is a pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. An inability to trust, doubts about others' loyalty, distortion and fabrication, misinterpretation, and bearing grudges unnecessarily are hallmarks of the disorder. Pathological jealousy, instinctive aggressive counter-attack, the need to control others, and the gathering of trivial or circumstantial "evidence" to support their jealous beliefs also feature.

Paranoia refers to gradually developing, systematized delusional states, without hallucinations or general personality deterioration but with preservation of intelligence, and with emotional responses and behaviour that remain congruous with and appropriate to the persecutory or grandiose delusions.

Paranoid patients are relatively rare in the mental hospital population. They constitute about 0.5% of first admissions and less than 1.5% of resident patients in mental hospitals in the USA. However, these figures probably underestimate the incidence of the illness in the population at large; many patients are able to control the socially disruptive manifestations of their delusions and are never hospitalized; others, especially where the disorder is less severe, are tolerated at home and at work as eccentrics.