Paranoia

Paranoia is a disturbed thought process characterized by excessive anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs concerning a perceived threat. In the original Greek, παράνοια (paranoia) simply means madness (para = outside; nous = mind) and, historically, this characterization was used to describe any delusional state.

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Use in psychiatry

More recently^[specify], the clinical use of the term has been used to describe delusions where the affected person believes they are being persecuted. Specifically, they have been defined as containing two central elements:

1. The individual thinks that harm is occurring, or is going to occur, to him or her.
2. The individual thinks that the persecutor has the intention to cause harm.

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. Paranoia can also be a side effect of medication or recreational drugs such as marijuana and particularly stimulants such as methamphetamine.

In the unrestricted use of the term, common paranoid delusions can 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.

Therefore, in common usage, the term paranoid addresses a range of mental conditions, assumed by the use of the term to be of psychiatric origin, in which the subject is seen to generalise or project fears and anxieties onto the external world, particularly in the form of organised behaviour focused on them. The syndrome is applied equally to powerful people like executives obsessed with takeover bids or political leaders convinced of plots against them, and to insignificant people who believe for instance that shadowy agencies are operating against them.

History

The term paranoia was used by Emil Kraepelin to describe a mental illness in which a delusional belief is the sole or most prominent feature. In his original attempt at classifying different forms of mental illness, Kraepelin used the term pure paranoia to describe a condition where a delusion was present, but without any apparent deterioration in intellectual abilities and without any of the other features of dementia praecox, the condition later renamed schizophrenia. Notably, in his definition, the belief does not have to be persecutory to be classified as paranoid, so any number of delusional beliefs can be classified as paranoia. For example, a person who has the sole delusional belief that he is an important religious figure would be classified by Kraepelin as having 'pure paranoia'.

See also

• Delusional disorder
• Distrust
• Ideas of reference
• Monomania
• Paranoid personality disorder
• Pronoia (psychology)
• Schizophrenia
• The Conversation - a film by Francis Ford Coppola which explores paranoia

Further reading

• Farrell, John. Paranoia and Modernity: Cervantes to Rousseau (Cornell University Press, 2006).
• Freeman, D. & Garety, P.A. (2004) Paranoia: The Psychology of Persecutory Delusions. Hove: Psychology Press. ISBN 1-84169-522-X
• Harper, David J. (1999) Deconstructing Paranoia:An Analysis of the Discourses Associated with the Concept of Paranoid Delusion.
• Igmade (Stephan Trüby et al, eds.), 5 Codes: Architecture, Paranoia and Risk in Times of Terror", Birkhäuser 2006. ISBN 3-7643-7598-1
• Kantor, Martin. (2004) Understanding Paranoia: A Guide for Professionals, Families, and Sufferers. Westport: Praeger Press. ISBN 0-275-98152-5
• Munro, A. (1999) Delusional disorder. Cambridge: Cambridge University Press. ISBN 0-521-58180-X
• Sims, A. (2002) Symptoms in the mind: An introduction to descriptive psychopathology (3rd edition). Edinburgh: Elsevier Science Ltd. ISBN 0-7020-2627-1
• Siegel, Ronald K. (1994) Whispers: The Voices of Paranoia. New York: Crown.
• Deconstructing Paranoia: An Analysis of the Discourses Associated with the Concept of Paranoid Delusion