paranoid disorders


Summary: Chronic mental disorders in which there has been an insidious development of a permanent and unshakeable delusional system (persecutory delusions or delusions of jealousy), accompanied by preservation of clear and orderly thinking. Emotional responses and behavior are consistent with the delusional state.

Top Publications

  1. Gracie A, Freeman D, Green S, Garety P, Kuipers E, Hardy A, et al. The association between traumatic experience, paranoia and hallucinations: a test of the predictions of psychological models. Acta Psychiatr Scand. 2007;116:280-9 pubmed
    ..Clear support was found for a link between trauma and psychosis mediated by negative beliefs about self and others. There may also be a direct association between re-experiencing symptoms and hallucinations. ..
  2. Udachina A, Varese F, Oorschot M, Myin Germeys I, Bentall R. Dynamics of self-esteem in "poor-me" and "bad-me" paranoia. J Nerv Ment Dis. 2012;200:777-83 pubmed publisher
    ..Our results suggest that paranoia can serve a defensive function in some circumstances. The reasons for inconsistencies in self-esteem research in relation to paranoia are discussed. ..
  3. Green C, Freeman D, Kuipers E, Bebbington P, Fowler D, Dunn G, et al. Measuring ideas of persecution and social reference: the Green et al. Paranoid Thought Scales (GPTS). Psychol Med. 2008;38:101-11 pubmed
    ..A reliable and valid tool for assessing paranoid thoughts is presented. It will provide an effective way for researchers to ensure consistency in research and for clinicians to assess change with treatment. ..
  4. Collip D, Oorschot M, Thewissen V, van Os J, Bentall R, Myin Germeys I. Social world interactions: how company connects to paranoia. Psychol Med. 2011;41:911-21 pubmed publisher
    ..Perceived social threat seems to be context dependent in the low paranoia group. However, at high levels of trait paranoia, momentary paranoia and momentary perceived social threat become autonomous and independent of social reality. ..
  5. Fornells Ambrojo M, Garety P. Bad me paranoia in early psychosis: a relatively rare phenomenon. Br J Clin Psychol. 2005;44:521-8 pubmed
    ..Stigma and depression are put forward as tentative explanations of the development of this evaluative belief with time. ..
  6. Ellett L, Freeman D, Garety P. The psychological effect of an urban environment on individuals with persecutory delusions: the Camberwell walk study. Schizophr Res. 2008;99:77-84 pubmed
    ..Further research is needed to clarify which aspects of urban environments cause the negative effects. Methodological challenges in the research area are raised. ..
  7. Lincoln T, Peter N, Schafer M, Moritz S. Impact of stress on paranoia: an experimental investigation of moderators and mediators. Psychol Med. 2009;39:1129-39 pubmed publisher
    ..The results support and specify the role of emotional reactions to stressors on the pathway from vulnerability to psychosis and highlight the relevance of anxiety. ..
  8. Freeman D, Pugh K, Vorontsova N, Southgate L. Insomnia and paranoia. Schizophr Res. 2009;108:280-4 pubmed publisher
    ..It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia. ..
  9. Campbell M, Morrison A. The relationship between bullying, psychotic-like experiences and appraisals in 14-16-year olds. Behav Res Ther. 2007;45:1579-91 pubmed
    ..The implications of these results are discussed. ..

More Information


  1. Startup H, Freeman D, Garety P. Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence. Behav Res Ther. 2007;45:523-37 pubmed
    ..If future research replicates these findings, worry reduction interventions for individuals with persecutory delusions may be warranted. ..
  2. Freeman D, Pugh K, Antley A, Slater M, Bebbington P, Gittins M, et al. Virtual reality study of paranoid thinking in the general population. Br J Psychiatry. 2008;192:258-63 pubmed publisher
    ..Paranoia can be understood in terms of cognitive factors. The use of virtual reality should lead to rapid advances in the understanding of paranoia. ..
  3. Freeman D, Garety P, Bebbington P, Slater M, Kuipers E, Fowler D, et al. The psychology of persecutory ideation II: a virtual reality experimental study. J Nerv Ment Dis. 2005;193:309-15 pubmed
    ..It is concluded that nonclinical paranoid thoughts are most closely associated with emotional disturbances and anomalous experiences. Extreme reasoning bias may particularly contribute to the development of clinical phenomena. ..
  4. Foster C, Startup H, Potts L, Freeman D. A randomised controlled trial of a worry intervention for individuals with persistent persecutory delusions. J Behav Ther Exp Psychiatry. 2010;41:45-51 pubmed publisher
    ..In the first trial specifically for persecutory delusions, a brief worry intervention was shown to have benefits. The results support a causal role for worry in paranoid experience. ..
  5. Lincoln T, Reumann R, Moritz S. Is there a functional way of responding to paranoid intrusions? Development of the Reactions to Paranoid Thoughts Scale. Cogn Neuropsychiatry. 2010;15:377-96 pubmed publisher
    ..It may prove beneficial to teach persons at risk of psychosis or those with attenuated symptoms new ways of responding to paranoid thoughts. ..
  6. Freeman D, Brugha T, Meltzer H, Jenkins R, Stahl D, Bebbington P. Persecutory ideation and insomnia: findings from the second British National Survey of Psychiatric Morbidity. J Psychiatr Res. 2010;44:1021-6 pubmed publisher
    ..Longitudinal studies of insomnia and paranoia, and tests of the effects of sleep interventions on levels of paranoia, are now required to examine causality. ..
  7. Martin J, Penn D. Social cognition and subclinical paranoid ideation. Br J Clin Psychol. 2001;40:261-5 pubmed
    ..These findings are tempered, however, by studying a nonclinical sample and the self-report measures of paranoid ideation that might be assessing multiple aspects of paranoid thought (e.g. ideas of reference). ..
  8. Cubells J, Kranzler H, McCance Katz E, Anderson G, Malison R, Price L, et al. A haplotype at the DBH locus, associated with low plasma dopamine beta-hydroxylase activity, also associates with cocaine-induced paranoia. Mol Psychiatry. 2000;5:56-63 pubmed
    ..Molecular Psychiatry (2000) 5, 56-63. ..
  9. Compton M, Goulding S, Bakeman R, McClure Tone E. Confirmation of a four-factor structure of the Schizotypal Personality Questionnaire among undergraduate students. Schizophr Res. 2009;111:46-52 pubmed publisher
    ..The four derived domains are minimally to moderately correlated with other measures of psychosis-proneness. ..
  10. Freeman D. Studying and treating schizophrenia using virtual reality: a new paradigm. Schizophr Bull. 2008;34:605-10 pubmed publisher
    ..VR, suitably applied, holds great promise in furthering the understanding and treatment of psychosis. ..
  11. Bebbington P, McBride O, Steel C, Kuipers E, Radovanovic M, Brugha T, et al. The structure of paranoia in the general population. Br J Psychiatry. 2013;202:419-27 pubmed publisher
    ..The paranoia continuum has implications for the aetiology, mechanisms and treatment of psychotic disorders, while confirming the lack of a clear distinction from normal experiences and processes. ..
  12. Freeman D. Suspicious minds: the psychology of persecutory delusions. Clin Psychol Rev. 2007;27:425-57 pubmed
    ..Ten key future research questions are identified, including the need for researchers to consider factors important to the different dimensions of delusional experience. ..
  13. Freeman D, Pugh K, Green C, Valmaggia L, Dunn G, Garety P. A measure of state persecutory ideation for experimental studies. J Nerv Ment Dis. 2007;195:781-4 pubmed
    ..The measure of paranoia in a recent social situation has good psychometric properties. ..
  14. Kalayasiri R, Sughondhabirom A, Gueorguieva R, Coric V, Lynch W, Lappalainen J, et al. Dopamine beta-hydroxylase gene (DbetaH) -1021C-->T influences self-reported paranoia during cocaine self-administration. Biol Psychiatry. 2007;61:1310-3 pubmed
    ..Results indicate that individuals homozygous for the 'very low-activity' T allele at DbetaH -1021C-->T show an increased propensity to paranoia over time during cocaine self-administration. ..
  15. Gelernter J, Panhuysen C, Weiss R, Brady K, Hesselbrock V, Rounsaville B, et al. Genomewide linkage scan for cocaine dependence and related traits: significant linkages for a cocaine-related trait and cocaine-induced paranoia. Am J Med Genet B Neuropsychiatr Genet. 2005;136B:45-52 pubmed
    ..35 for membership in the "Moderate Cocaine and Opioid Abuse" cluster on chromosome 18. These results provide a basis for the identification of specific genes contributing to risk for these traits. ..
  16. McKay R, Langdon R, Coltheart M. Paranoia, persecutory delusions and attributional biases. Psychiatry Res. 2005;136:233-45 pubmed
    ..These results suggest that the putative link between persecutory ideation and attributional biases only manifests (if at all) when persecutory ideation is of delusional intensity, and that it is confined to a personalising bias. ..
  17. Fowler D, Freeman D, Smith B, Kuipers E, Bebbington P, Bashforth H, et al. The Brief Core Schema Scales (BCSS): psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychol Med. 2006;36:749-59 pubmed
    ..The BCSS may provide a more useful measure of schemata about self and others than traditional measures of self-esteem. ..
  18. Freeman D, Slater M, Bebbington P, Garety P, Kuipers E, Fowler D, et al. Can virtual reality be used to investigate persecutory ideation?. J Nerv Ment Dis. 2003;191:509-14 pubmed
    ..Virtual reality may prove to be a valuable methodology for developing an understanding of persecutory ideation. ..
  19. Freeman D, Garety P, Bebbington P, Smith B, Rollinson R, Fowler D, et al. Psychological investigation of the structure of paranoia in a non-clinical population. Br J Psychiatry. 2005;186:427-35 pubmed
    ..Suspiciousness is common and there may be a hierarchical arrangement of such thoughts that builds on common emotional concerns. ..
  20. Thewissen V, Bentall R, Oorschot M, a Campo J, van Lierop T, Van Os J, et al. Emotions, self-esteem, and paranoid episodes: an experience sampling study. Br J Clin Psychol. 2011;50:178-95 pubmed publisher
    ..Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking. ..
  21. Burgess P, Bindman J, Leese M, Henderson C, Szmukler G. Do community treatment orders for mental illness reduce readmission to hospital? An epidemiological study. Soc Psychiatry Psychiatr Epidemiol. 2006;41:574-9 pubmed
    ..The risk also declined over the study period. The effect of using a CTO depends on the patient's history. At a population level their introduction may not reduce readmission to hospital. Their impact may change over time. None. ..
  22. Sachdev P, Smith J, Cathcart S. Schizophrenia-like psychosis following traumatic brain injury: a chart-based descriptive and case-control study. Psychol Med. 2001;31:231-9 pubmed
    ..A genetic predisposition to schizophrenia and severity of injury with significant brain damage and cognitive impairment may be vulnerability factors. ..
  23. Drozdz W, Borkowska A, Wilkosc M, Halota W, Dybowska D, Rybakowski J. Chronic paranoid psychosis and dementia following interferon-alpha treatment of hepatitis C: a case report. Pharmacopsychiatry. 2007;40:146-8 pubmed
    ..The possibility of severe neuropsychiatric adverse effects of interferon-alpha therapy in a susceptible individual may necessitate regular psychiatric consultations during the treatment. ..
  24. Floyd A, Boutros N, Struve F, Wolf E, Oliwa G. Risk factors for experiencing psychosis during cocaine use: a preliminary report. J Psychiatr Res. 2006;40:178-82 pubmed
    ..044). The data suggest that early age of initiation of regular cocaine use occurring during vulnerable periods of brain development, may lead to increased severity of CIP. ..
  25. Bourne V, McKay R. Paranoid males have reduced lateralisation for processing of negative emotions: an investigation using the chimeric faces test. Laterality. 2014;19:235-52 pubmed publisher
    ..For females there were no significant relationships. These findings suggest that atypical patterns of lateralisation for processing emotional stimuli may be implicated in, or associated with, increased levels of paranoia. ..
  26. Simons C, Wichers M, Derom C, Thiery E, Myin Germeys I, Krabbendam L, et al. Subtle gene-environment interactions driving paranoia in daily life. Genes Brain Behav. 2009;8:5-12 pubmed publisher
    ..Thus, paranoia in the flow of daily life may be the result of gene-environment interactions that can be traced to different types of stress being moderated by different types of genetic variation. ..
  27. Sepić Grahovac D, Ružić Baršić A, Ružić K, Grahovac T, Dadić Hero E. Neurological and psychiatric aspects of corpus callosum genesis. Psychiatr Danub. 2010;22:282-5 pubmed
    ..Mild cognitive impairment and late epilepsy onset require a multidisciplinary approach since the patient also displays elements of central nervous system malformations. ..
  28. Seidel M. [Albert Schweitzer's MD thesis on Criticism of the medical pathographies on Jesus]. Wurzbg Medizinhist Mitt. 2009;28:276-300 pubmed
    ..These positions precede the way Albert Schweitzer is reconsidered as author in cultural studies and ethicist. The fact that this happened immediately before the beginning of the WWI may show his farsightedness. ..
  29. Corcoran R, Bentall R, Rowse G, Moore R, Cummins S, Blackwood N, et al. Making sense of theory of mind and paranoia: the psychometric properties and reasoning requirements of a false belief sequencing task. Cogn Neuropsychiatry. 2011;16:547-61 pubmed publisher
    ..This measure is best suited for assessing ToM functioning where participants' performance falls just short of the average latent ToM ability. Furthermore, it is sensitive to the effects of increasing age and decreasing IQ. ..
  30. Avgoustinaki P, Mitsopoulou E, Chlouverakis G, Triantafillou T, Venihaki M, Koukouli S, et al. Sex steroids and personality traits in the middle luteal phase of healthy normally menstruating young professional women. Hormones (Athens). 2012;11:333-43 pubmed
    ..81, p=0.057). We have found that total testosterone was associated with the paranoia score, the metabolic product of activated androgens, 3alpha-diolG, to social introversion and, finally, progesterone to obsessive-compulsive behavior. ..
  31. Moutoussis M, Bentall R, El Deredy W, Dayan P. Bayesian modelling of Jumping-to-Conclusions bias in delusional patients. Cogn Neuropsychiatry. 2011;16:422-47 pubmed publisher
  32. Michail M, Birchwood M. Social anxiety disorder in first-episode psychosis: incidence, phenomenology and relationship with paranoia. Br J Psychiatry. 2009;195:234-41 pubmed publisher
    ..For a subgroup of socially anxious people with psychosis, anticipated harm is present and the processes that underlie its relationship with social anxiety warrant further investigation. ..
  33. Retief F, Wessels A. Was Stalin mad?. S Afr Med J. 2008;98:526-8 pubmed
  34. Schulze T, Ohlraun S, Czerski P, Schumacher J, Kassem L, Deschner M, et al. Genotype-phenotype studies in bipolar disorder showing association between the DAOA/G30 locus and persecutory delusions: a first step toward a molecular genetic classification of psychiatric phenotypes. Am J Psychiatry. 2005;162:2101-8 pubmed
    ..These data suggest that bipolar affective disorder with persecutory delusions constitutes a distinct subgroup of bipolar affective disorder that overlaps with schizophrenia. ..
  35. Krishna N, Chiappelli J, Fischer B, Knight S. Tacrolimus-induced paranoid delusions and fugue-like state. Gen Hosp Psychiatry. 2013;35:327.e5-327.e6 pubmed publisher
    ..Treatment usually calls for prompt discontinuation of tacrolimus, substituting with another immunosuppressant, and possible use of antipsychotics. ..
  36. Jordan H, Lockert E, Johnson Warren M, Cabell C, Cooke T, Greer W, et al. Erotomania revisited: thirty-four years later. J Natl Med Assoc. 2006;98:787-93 pubmed
    ..Finally, we will argue that this disorder is not as rare as has been claimed and call for the continued recognition of this syndrome as its own entity despite recent opinions that such use be discontinued. ..
  37. Valiente C, Prados J, Gómez D, Fuentenebro F. Metacognitive beliefs and psychological well-being in paranoia and depression. Cogn Neuropsychiatry. 2012;17:527-43 pubmed publisher
    ..These findings suggest that psychological well-being is particularly compromised in participants with a high level of persecutory thinking when they have low levels of cognitive self-consciousness. ..
  38. Tremeau F, Antonius D, Todorov A, Rebani Y, Ferrari K, Lee S, et al. What can the study of first impressions tell us about attitudinal ambivalence and paranoia in schizophrenia?. Psychiatry Res. 2016;238:86-92 pubmed publisher
    ..Consistent with research on paranoia and self-esteem, actively-paranoid patients' positive social traits judgments were of higher intensity than non-paranoid patients'. ..
  39. van Dongen J, Buck N, van Marle H. The role of ideational distress in the relation between persecutory ideations and reactive aggression. Crim Behav Ment Health. 2012;22:350-9 pubmed publisher
    ..Facilitation of early detection of experienced delusional distress may lead to development of more specific psychotherapeutic interventions to manage violence risk. ..
  40. Wong S, Kletter H, Wong Y, Carrion V. A prospective study on the association between caregiver psychological symptomatology and symptom clusters of pediatric posttraumatic stress disorder. J Trauma Stress. 2013;26:385-91 pubmed publisher
    ..These results suggest caregiver symptomatology may be specifically associated with hyperarousal symptoms in pediatric trauma. ..
  41. Palmier Claus J, Dunn G, Drake R, Lewis S. The negative and positive self: a longitudinal study examining self-esteem, paranoia and negative symptoms in individuals with first-episode psychosis. Early Interv Psychiatry. 2011;5:150-5 pubmed publisher
    ..Self-esteem boosting interventions administered in the first 6 weeks after admission to healthcare services may improve the subsequent course of negative symptoms. ..
  42. Goforth H, Rao M, Sucholeiki R. Chronic interictal psychosis responsive to aripiprazole. J Clin Psychopharmacol. 2004;24:573-4 pubmed
  43. Mauerer C, Schuler M, Bär W, Wolfersdorf M, Adler L. [Differentialdiagnostic problems of frontotemporal dementia--a case study]. Psychiatr Prax. 2004;31 Suppl 1:S137-9 pubmed
    ..A case study on the clinical picture of frontotemporal dementia and the differential diagnostic problems will be described. ..
  44. Serretti A, Lattuada E, Cusin C, Lilli R, Lorenzi C, Smeraldi E. Dopamine D3 receptor gene not associated with symptomatology of major psychoses. Am J Med Genet. 1999;88:476-80 pubmed
    ..DRD3 variants were not associated with these symptomatologic factors, and consideration of possible stratification effects, such as sex and psychiatric diagnosis, did not reveal any association either. ..
  45. Combs D, Penn D, Chadwick P, Trower P, Michael C, Basso M. Subtypes of paranoia in a nonclinical sample. Cogn Neuropsychiatry. 2007;12:537-53 pubmed
    ..The implications of these subtypes for the study of paranoia are discussed. ..
  46. Claude H, Schiff P. [Delirium of the interpretation based on Kretschmer's affective disorders and its relation to external action syndrome. 1928]. Encephale. 2007;33 Spec No 2:S425-7 pubmed
  47. Albert K. [Investigation of the life situation of schizophrenic and paranoid patients at the Mental Health Care Institution in the City of Debrecen]. Psychiatr Hung. 2006;21:437-43 pubmed
    ..In these important tasks, both psychiatric nursing taking place in the residential area (community psychiatry) and social care will play an indispensable role. ..
  48. Quanbeck C, McDermott B, Lam J, Eisenstark H, Sokolov G, Scott C. Categorization of aggressive acts committed by chronically assaultive state hospital patients. Psychiatr Serv. 2007;58:521-8 pubmed
  49. Mendez M, Shapira J, Saul R. The spectrum of sociopathy in dementia. J Neuropsychiatry Clin Neurosci. 2011;23:132-40 pubmed publisher
    ..Two common mechanisms are disinhibition, with frontally predominant disease, and agitation-paranoia, with greater cognitive impairment. These forms of sociopathy differ significantly from the antisocial/psychopathic personality. ..
  50. Johansson A, Nikamo P, Schalling M, Landen M. Polymorphisms in AKR1C4 and HSD3B2 and differences in serum DHEAS and progesterone are associated with paranoid ideation during mania or hypomania in bipolar disorder. Eur Neuropsychopharmacol. 2012;22:632-40 pubmed publisher
    ..31 (95% CI 0.10-0.96)) but did not correlate with hormone concentrations. Hence, gene variants in the steroidogenetic pathway and steroids concentration differences may be involved in the susceptibility to paranoia during mood elevation. ..
  51. Zanarini M, Frankenburg F, Vujanovic A, Hennen J, Reich D, Silk K. Axis II comorbidity of borderline personality disorder: description of 6-year course and prediction to time-to-remission. Acta Psychiatr Scand. 2004;110:416-20 pubmed
    ..They also suggest that anxious cluster disorders are the axis II disorders which most impede symptomatic remission from BPD. ..
  52. Richartz E, Wormstall H. A case of paranoia with severe consequences. From a historical approach to a multidimensional understanding of chronic delusional disorder. Psychopathology. 2001;34:104-8 pubmed
  53. Grant J, Scherrer J, Lyons M, Tsuang M, True W, Bucholz K. Subjective reactions to cocaine and marijuana are associated with abuse and dependence. Addict Behav. 2005;30:1574-86 pubmed
    ..7; 95% CI: 5.6-62.6) classes. We found evidence for both qualitative and quantitative subjective effect profiles. Subjective effects, both positive and adverse are associated with lifetime risk for marijuana and cocaine dependence. ..