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Paranoid personality disorder

A person diagnosed with a paranoid personality disorder (PDD) is likely to be suspicious of others and unlikely to trust them.

Paranoid personality disorder is one of a group of conditions called eccentric personality disorders.

What are the symptoms of PPD?

People with PPD are always on guard, believing that others are constantly trying to demean, harm or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, might interfere with their ability to form close relationships. People with this disorder:

  • Doubt the commitment, loyalty or trustworthiness of others, believing others are using or deceiving them
  • Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them
  • Are unforgiving and hold grudges
  • Are hypersensitive and take criticism poorly
  • Read hidden meanings in the innocent remarks or casual looks of others
  • Perceive attacks on their character that are not apparent to others - they generally react with anger and are quick to retaliate
  • Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful
  • Are generally cold and distant in their relationships with others, and might become controlling and jealous
  • Cannot see their role in problems or conflicts and believe they are always right
  • Have difficulty relaxing
  • Are hostile, stubborn and argumentative

What causes PPD?

The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia suggests a genetic link between the two disorders. Early childhood experiences (including physical or emotional trauma) are also suspected of playing a role in the development of PPD.

How is PPD diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, doctors who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How is PPD treated?

People with PPD often do not seek treatment on their own because they do not see themselves as having a problem. When treatment is sought psychotherapy (a form of counselling) is recommended for PPD. Treatment often focuses on increasing general coping skills, as well as on improving social interaction, communication and self-esteem.

Because trust is an important factor of psychotherapy, treatment is challenging since people with PPD have such distrust of others. As a result many people with PPD do not follow their treatment plan.

Medication generally is not used to treat PPD. However, drugs such as anti- anxiety, antidepressant or anti-psychotic tablets might be prescribed if the person's symptoms are extreme, or if he or she also has an associated psychological problem such as anxiety or depression.

WebMD Medical Reference

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