Paranoid personality disorder (PPD), is a mental condition characterized by prolonged pattern of mistrust and suspicion towards other individuals.
People with PPD are always under the belief that others are constantly trying to harm, exploit and demean them. Their habit of mistrust and doubt hampers them from forming close relationships with others. In addition to these, other common symptoms include [5]:
Paranoid disorders are diagnosed on the basis of personal and family history and if required physical examination. There are no laboratory tests to diagnose these disorders [6]. Following this, a psychological assessment is conducted which would include gathering information about school, work, childhood memories and relationships. Psychologists have specially designed medical tools and interview questions through which they can assess these disorders. The responses given by the individuals help in assessment of the condition [7].
Care must be taken to interact with these people as once mistrust developed, they may lose their chance of being treated. An honest, simple and concrete approach is likely to be benefited from. Current difficulties of life of the patient should be discussed and the therapist should not try to go deep into the aspects of the patient’s life [8].
Personality disorder is treated by psychotherapy, which involves teaching coping skills to the patient to help them deal with different situations. Persons are encouraged to develop social interaction, self esteem and communication with others [9].
Medicines generally are not a part of treatment, unless required. Medications like antianxiety, antipsychotic drugs and antidepressants can be given to treat anxiety and depression when these condition appear as secondary complications to PPD.
Medications are contraindicated since they can lead to unnecessary suspicion and treatment dropout. Medications if indicated for any conditions should be given for briefest time possible in order to bring the condition under control.
An antianxiety agent, diazepam, is prescribed if the patient suffers from severe anxiety or agitation that interferes with the normal day to day life activities. An antipsychotic medication, like thioridazine or haloperidol, may be appropriate if a patient presents with symptoms of delusion, selfharm or harm to others [10].
Long-term prognosis for paranoid disorder is not good. Individuals who suffer from the disorder show prominent symptoms throughout their lives. Treatment approach with group and family therapy is not recommended.
People suffering from these disorders hardly present themselves for treatment; hence in most of the cases the symptoms and behavior of these patients are present throughout the lifetime. All mental health personnel who treat individuals suffering from paranoid personality disorder should adopt a straight-forward approach. Humorous behavior and information not received directly from them will create a great deal of suspicion.
Paranoid personality disorder may arise due to many factors such as social, psychological and genetic factors. It depends on the individual personality that is shaped by the environment and the surroundings, the temperament as well the ability to deal with stress in daily life.
Other reasons are emotional and physical trauma experienced in the early childhood. People suffering from paranoid personality disorder may have close relatives suffering from schizophrenia which ultimately predisposes them to develop the condition [2].
PPD is a common occurrence amongst the male population. It has been estimated that about 10 to 15% of the US population are affected by personality disorders. Of these, 0.5 to 2.5% account for PPD [3]. Such a type of personality disorder usually occurs in early adulthood.
In patients with paranoid personality disorder, abnormalities are seen in the frontal, temporal, and parietal lobes. These can be a result of trauma, encephalitis and genetics. Diminishing monoamine oxidase (MAO) and serotonin levels may also be a reason. History of psychiatric disorders is present in some cases and the patient has developmental abnormalities in other cases [4].
Prevention of paranoid personality disorder involves counseling the person. It includes teaching the person more productive ways of dealing with stress and coping with day to day life situations. Stress management can be taught to the person to cope up with his suspicious behavior. A straight forward approach and healthy interaction with the patient can help to resolve the situation.
The person with this disorder thinks that people will harm, deceive and exploit them, even when there is nothing obvious to support this. People have a suspicious and malevolent behavior towards others. Paranoid personality disorder (PPD) is amongst a group of conditions called "Cluster A" personality disorders that are presented with odd or eccentric ways of thinking and perception. Some kind of Paranoia is normal in every person. People with this disorder have paranoia to extremes; they suspect everyone can harm them. It gravely affects their professional and personal life [1].