DEFINITION: People with an unfounded, pervasive, general mistrust of others may be diagnosed as paranoid. Personality disorders are diagnosed from long-standing, maladaptive behaviors and thoughts, often beginning in adolescence or early adulthood.

People with paranoid personality disorder (PPD) usually do not see themselves as having a problem and, consequently, do not seek treatment until they have a crisis in their social, business, or personal lives.

IDENTIFYING FEATURES for DIAGNOSIS of PPD is based on a person presenting with four or more of the following, enduring symptoms:
1) Unfounded suspicion of others; believes they are deceiving, harming, or exploiting him
2) Doubts the commitment, loyalty or trustworthiness of others
3) Reluctance to confide in others because he thinks they'll betray him
4) Reads hidden meanings into innocent remarks, which he sees as demeaning or threatening
5) Is begrudging and unforgiving
6) Misconstrues innocent remarks from others as attacking his personal character or reputation, and reacts with anger
7) Acts suspicious that his sexual partner is unfaithful, without cause

People with PPD are often: pathologically jealous; critical of others and hypersensitive to personal criticism; unable to relax; humorless; cold, distant, and unemotional; and they are often quite controlling.

Such people usually cannot see their own role in creating problems or conflicts. They believe they are always right, which can cause them to be hostile, stubborn and argumentative.

Differential diagnosis: PPD should not feature any actual psychotic tendencies and, by definition, cannot be related to another general medical condition. Paranoid schizophrenia, by contrast, is a distinct psychotic disorder in which the individual feels he is constantly being watched, followed, or persecuted.

CAUSES: It appears likely that the disorder involves biological and psychological components. PPD seems to be closely correlated to families with schizoid and schizotypal personality disorders. It affects about .5% to 2.5% of the general population and seems to affect more men than women.

People with PPD often end up in legal battles, suing those they feel are "out to get them." Constantly feeling slighted, always hypersensitive and hyper-vigilant, their lives can be quite constricted.

By definition, PPD is a chronic disorder but few seek help. Sometimes, a person faces a crisis that might bring him to seek medical attention.

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