Paranoigenic Extremes - a Reappraisal Concerning Paranoid Personality Disorder

Background: Paranoid personality disorder refers to an extensive and enduring psychosocial dysfunction typified by a penetrating pattern of manifestations like hypersensitivity, selfreference, and mistrust. Even though it is continuously represented in DSM and ICD, its diagnostic status has been intermittently questioned. Objective: Provide a brief review on paranoid personality disorder with particular emphasis on sociodemographic characteristics, psychopathology, and course. Method: Literature review. Results: While research suggests that the disorder is not rare in the community, the diagnosis is comparatively seldom made in psychiatric hospital. But if so, the characteristic patient is a young-tomiddle- aged male. Co-morbid mental disorder and depressive symptoms habitually appear and full blown paranoid symptoms sometimes may supervene. However, the presence of, for example, another schizophrenia spectrum disorder or primary organic illness should be ruled out. Usually the course is chronic, and there may be difficulties with staying in the labor market. Management is challenging and must address the pervasive paranoigenic mechanisms and extreme behavior. Although scientific support is limited, psychotherapy and possibly psychopharmacological agents may be treatments of choice. Conclusion: The concept of paranoid personality disorder has received a substantial scientific support though research is needed, perhaps most of all, to inform future diagnostic measures and care recommendations.