Paranoid Schizophrenia: Definition, Symptoms, Diagnosis and Treatment

The Paranoid schizophrenia is the most common form of schizophrenia , it is a type of brain disorder. In 2013, the American Psychiatric Association recognized that paranoia was one of the positive symptoms of schizophrenia, not a separate diagnostic condition.

If you have it, schizophrenia can make it difficult for you to distinguish between reality and fantasy. In turn, symptoms can significantly affect the way you perceive and interact with the world. Not all people with schizophrenia will develop paranoia, however paranoia is a significant symptom. It is important to be able to recognize early symptoms so that you can seek treatment and improve your quality of life.

What is paranoid schizophrenia?

Paranoid schizophrenia, or schizophrenia with paranoia, as doctors now call it, is the most common example of this mental illness.

Schizophrenia is a kind of psychosis, which means that your mind does not agree with reality. It affects how you think and behave, this can appear in different ways and at different times, even in the same person. The disease usually begins in the late teens or early adulthood.

People with paranoid delusions are irrationally distrustful of others, this can make it difficult for them to have a job, run errands, have friends, and even go to the doctor. Although it is a lifelong disease, you can take medicine and seek help to stop the symptoms or make them easier to live with.

The average age of onset is late adolescence through early adulthood, generally between the ages of 18 to 30, it is highly unusual for schizophrenia to be diagnosed after age 45 or before age 16. Onset in men generally occurs earlier in life than women.

Symptoms of Paranoid Schizophrenia

This condition has marked symptoms that can evolve and even improve over time. Not everyone will experience paranoia with schizophrenia. Some will develop other symptoms, such as:


Delusions are deeply held beliefs that are not true, there are many different types of delusions. Some of the more common types include:

  • Delusions of control:  You may believe that you are being controlled by an outside force, such as the government or foreigners.
  • Delusions of Grandeur: You may believe you have exceptional abilities, wealth, or importance.
  • Delusions of persecution: This is the belief that everyone (or maybe just one person) wants to get you.
  • Reference delusions: You may believe that an otherwise insignificant item was designed specifically for you.

About 90 percent of people with schizophrenia experience delusions, not all of them will have the same types of delusions.


Hallucinations are sensations of things that you perceive as real that do not really exist, hearing voices is the most common hallucination in schizophrenia with paranoia. The voices can even be attributed to people you know.

Symptoms can be worse when you are isolated from others.

disorganized speech

If you have schizophrenia, you can also have disorganized speech, you can repeat words or phrases or start speaking in the middle of a sentence, you can even make up your own words, this symptom is the result of concentration difficulties common with schizophrenia. Disorganized speech in this disorder is not the same as a speech disorder .

Disorganized behavior

Disorganized behavior refers to a general inability to control your behavior in all contexts, such as at home and work. You may have problems:

  • Performing ordinary daily activities.
  • Controlling your impulses.
  • Keeping your emotions in check.
  • Behaviors that are considered strange or inappropriate.

This symptom can affect your work, social and home life.

Negative symptoms

Negative symptoms refer to the lack of behaviors found in people who do not have schizophrenia. For example, negative symptoms can include:

  • Anhedonia, or lack of enthusiasm for activities that are generally perceived as fun
  • Lack of emotions
  • Dull expression
  • Decline of general interest in the world

Suicidal thoughts

Suicidal thoughts and behaviors are another common symptom of schizophrenia, occurring more often in cases that are not treated. If you or someone you know has thoughts of suicide or self-harm, call your local emergency services right away, they can connect you with a mental health professional who can help you.

Causes of paranoid schizophrenia

The exact causes are unclear, but they likely involve a combination of genetic factors and environmental triggers. Symptoms can be the result of an imbalance of dopamine and possibly serotonin, which are neurotransmitters.

Risk factors include:


Having a family history of schizophrenia increases your risk of developing it. If there is no family history, the chances of developing it are less than 1 percent, if a parent had the condition, there is a 10 percent chance of developing it.

Other factors that can contribute:

  • A viral infection in the mother while she was pregnant.
  • Malnutrition before birth.
  • Stress , trauma, or child abuse.
  • Problems during delivery.

Stressful experiences

They often occur before a diagnosis of schizophrenia. Before acute symptoms appear, the person may begin to experience a short temper, anxiety, and poor concentration, this can lead to relationship problems.

It is difficult to know if paranoid schizophrenia causes certain stresses, or if it occurs as a result of them.

Drug’s use

They can affect the mind and mental processes has been linked to schizophrenia, it is unclear if this is a cause or an effect. One argument is that psychoactive drug use can trigger symptoms in those who are susceptible.

People with this condition can use cannabis because they enjoy it more, some say it helps them deal with their symptoms.

Possible Complications of Paranoid Schizophrenia

People who undergo treatment for this type of schizophrenia may improve to a point where symptoms are mild or almost absent. Lifelong treatment is required to prevent other conditions associated with the disorder from occurring, such as:

  • Alcoholism.
  • Anxiety disorders
  • Depression.
  • Drug addiction.
  • Self harm.
  • Suicide.

Untreated schizophrenia can become disabling. In severe cases, people who do not seek treatment run the risk of being homeless and jobless.

Diagnosis of paranoid schizophrenia

A doctor will ask about the patient’s medical and family history and perform a physical exam. Diagnostic tests may include a blood test to rule out other possible causes of symptoms, such as thyroid dysfunction, alcohol and drug use.

Imaging scans such as a CT scan can reveal brain lesions or any abnormalities in the structure of the brain. An EEG can assess brain function.

There will also be a psychological evaluation.

The psychiatrist will ask the patient about their thoughts, feelings, and behavior patterns and about their symptoms, when they started, their severity, and their impact on daily life. They will try to find out how often and when the episodes have occurred, and if the patient has had any thoughts about harming himself or others, talking to friends and family may be helpful.

Treatment for paranoid schizophrenia

Counseling can help the patient develop and maintain social, work, and life skills. Schizophrenia and paranoia can last a lifetime, but treatment can help relieve symptoms.

Treatment should continue, even when symptoms appear to have subsided, if treatment is stopped, symptoms often reappear, especially if they have already returned after stopping the medications.

The options depend on the severity and type of symptoms, age, and other factors.


When paranoid schizophrenia is diagnosed, antipsychotic medication is usually prescribed, this can be administered as a pill, a patch, or an injection. Long-term injections have been developed that could eliminate the problems of a patient who does not take his medicine regularly (known as “medication non-compliance”). This is a common concern in schizophrenia due to the symptom of anosognosia.

Anosognosia is the lack of knowledge and lack of knowledge of the presence of a disorder, it is possible that a person with schizophrenia does not recognize that their behavior, hallucinations or delusions are unusual or unfounded. This can cause a person to stop taking antipsychotic medications, stop participating in therapy, or both, which can lead to a relapse into active-phase psychosis.


A person with severe symptoms may need hospitalization, this can help keep the person safe, provide adequate nutrition, and stabilize sleep. Partial hospitalization is sometimes possible.

Compliance or adherence in medicine can be difficult for people with schizophrenia, if they stop taking their medicine, the symptoms can return. Hospitalization can help people get back on their medications while keeping them safe.

Psychosocial treatment

The psychotherapy , counseling and training in social and vocational skills can help the patient to live independently and reduce the chances of relapse. Support can include improving communication skills, finding work and housing, and joining a support group.

Electroconvulsive therapy

Electroconvulsive therapy involves sending an electrical current through the brain to produce controlled seizures or seizures, the seizure is believed to trigger a massive neurochemical release in the brain. Side effects can include short-term memory loss , it is effective in treating catatonia, a syndrome that occurs in some people with schizophrenia.

It can help patients who have not responded to other treatments. Patients often stop taking their medication within the first 12 months of treatment, requiring lifelong support.

Caregivers and family members can help the person who has a diagnosis by learning as much as possible about schizophrenia and encouraging the patient to adhere to their treatment plan.

How to deal with this type of schizophrenia?

Managing paranoid schizophrenia requires self-care, do your best to follow these tips:

  • Manage your stress levels. Avoid situations that increase stress and anxiety, be sure to take time to relax, you can read, meditate or go for a walk.
  • Eat a healthy diet. Plant-based foods and non-packaged items can boost your energy levels and make you feel better.
  • Get regular exercise. Staying physically active increases serotonin, the “feel good” chemical in your brain.
  • Hold social events. Maintaining social commitments will help decrease isolation, which can make your symptoms worse.
  • Get enough sleep. Lack of sleep can make paranoia, delusions, and hallucinations worse in people with schizophrenia.
  • Avoid unhealthy behaviors, including smoking, alcohol use, and drug abuse.

Georgia Tarrant
 | Website

Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.