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Back to Psychiatry Diseases
Paranoia
Paranoia is excessive concern about one's own well being, sometimes
suggesting the person holds persecutory beliefs concerning a threat to
themselves or their property.
In the original Greek (paranoia) means self-referential, and it is this
meaning which has been adopted in psychiatry, especially European
psychiatry, in reference to a delusional belief (see delusions).
Specifically, the term paranoia is used to denote a delusional belief
that is self-referential (see also ideas of reference). The delusional
belief may not necessarily be persecutory. For example, a person who has
a delusional belief that they are an important figure (such as being
Jesus, Napoleon, or the Dalai Lama) may be diagnosed as having a
paranoid belief or, if they hold this belief in the context of
schizophrenia, as having paranoid schizophrenia. Paranoia and delusions
in general are considered an important (if not the most important)
diagnostic feature of psychosis.
The term 'paranoia' was previously used in psychiatry used to describe
an isolated delusion. The presence of one of these in the absence of
other symptoms of dementia praecox led Emil Kraepelin to create the
diagnostic category of 'pure paranoia'. This diagnostic category is
covered by what is now classified as delusional disorder. That is, a
mental illness that involves one or more non-bizarre delusions with the
absence of any other psychopathology (signs or symptoms of mental
illness).
Common paranoid delusions may include the belief that the person is
being followed, poisoned or loved at a distance (often by a media figure
or important person, a delusion known as erotomania or De Clerambault
syndrome). Other common paranoid delusions include the belief that the
person has an imaginary disease or parasitic infection (delusional
parasitosis), that the person is on a special quest or has been chosen
by God, that the person has had thoughts inserted or removed from
conscious thought or that the person's actions are being controlled by
an external force (see mind control).
Paranoia is often associated with psychotic illnesses, particularly
schizophrenia, although attenuated features may be present in other
primarily non-psychotic diagnoses, such as paranoid personality
disorder.
Many despotic rulers (for example Stalin) allegedly suffered from
paranoia. This presents an interesting question because in Stalin's
case, it is quite likely that many people really were out to get him
(some theories state he was finally poisoned). Might it be that with
enough enemies, it is impossible to be clinically paranoid? This begs
interesting philosophical questions about the criteria by which we can
diagnose a belief as paranoid or delusional.
Clinically, paranoid beliefs can be categorised into a number of types,
although these are now listed as sub-types of delusional disorder (see
that article for more details).
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