Paranoid Schizophrenia: Definition, Symptoms, and Treatment

What Is Paranoid Schizophrenia?

“Someone is following me” or “My family wants to lock me away” — these are just some of the delusions that a person who suffers from paranoid schizophrenia may experience. Paranoid schizophrenia is often characterized by delusions that others are persecuting, tracking, or otherwise monitoring a person. This article will describe how mental health professionals can recognize a person may be suffering from paranoid schizophrenia.

Doctors don’t know exactly what causes paranoid schizophrenia. They believe that schizophrenia causes may be due to a combination of factors, including family history, brain chemistry changes, environmental influences, and even substance use history.

What Are the DSM-5-TR Diagnostic Criteria for Paranoid Schizophrenia?

The Diagnostic and Statistical Manual-V is the manual most mental health professionals use to diagnose disorders such as schizophrenia. The DSM-5-TR specifies six diagnostic criteria for schizophrenia (this includes all types, not just paranoid):

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Catatonic behavior or “grossly disorganized” behavior
  • Negative symptoms, which include avolition, or a lack of motivation
  • Significant behavioral disturbance such that a person does not work or interact with others well over the course of six months

A person must have at least two of the first five symptoms over the course of one month for a mental health professional to diagnose a person with schizophrenia.

What Are the Symptoms of Paranoid Schizophrenia?

Over time, the DSM’s classifications of schizophrenia subtypes have changed. The DSM-1 identified nine separate types of schizophrenia. The DSM-5-TR does not break schizophrenia down into different subtypes. The reason for this may be the lack of clinical value in defining separate types.

However, mental health professionals may recognize several clinical “subtypes” of schizophrenia. These include disorganized, catatonic, undiferentiated, and paranoid. Doctors often regard paranoid schizophrenia as the most common subtype. One study of 731 patients diagnosed with schizophrenia found that 82 percent had paranoid schizophrenia. Undifferentiated is the next-most common type with about 9 percent of those with schizophrenia having symptoms of this type.

A person with paranoid schizophrenia will typically have paranoid delusions. This means that a person may think friends and family are “out to get them.” They may believe there are conspiracies of government or religion that are targeting the person, such as that the FBI is following the person.

Because a person with paranoid delusions cannot recognize the thoughts they have aren’t “real,” the paranoia can overtake their life. They may avoid going outdoors due to fears of someone following them. They may alienate friends and family due to their suspicions their family are conspiring against them.

Can You Recover From Paranoid Schizophrenia?

Currently, there is no cure for paranoid schizophrenia or any other schizophrenia subtype. Doctors do, however, have several treatments that can help a person better cope with their symptoms. Examples of these include anti-psychotic medications as well as individual and family counseling. Counseling may focus on helping a person recognize their delusions, learn how to process their thoughts, or enhance a person’s ability to communicate with others. This can be very difficult to accomplish because the delusions and paranoia feel very real to the person experiencing them.

Ideally, the goals for paranoid schizophrenia treatment are to keep a person out of a state of psychosis, where they lose touch with reality. However, many patients with paranoid schizophrenia may require a hospital stay if they experience an acute episode of paranoid psychosis. Through consistent treatment, a person can ideally manage their paranoid schizophrenia symptoms.

Paranoid schizophrenia can significantly affect a client, their friends, and family. For more in-depth learning on paranoid schizophrenia, view Symptom Media’s CE Courses and video case studies.