I. See Also

II. Definition

  1. Odd or eccentric personalities

III. Signs: General features for all cluster A personalities

  1. Fantasy to eccentric
  2. Lonely to schizoid
  3. Distortion or Delusion to Paranoid
  4. Projective identification
  5. Projection of guilt (blame someone else)

IV. Type: Paranoid Personality

  1. Characteristics (onset as adult)
    1. Aloof and emotionally cold
    2. Pervasive mistrust and suspicion without sufficient cause, that others are exploiting, harming or deceiving him or her
    3. Unjustified doubts about other's loyalty or trustworthiness
    4. Reads into benign remarks or events, hidden demeaning or threatening meanings
    5. Persistently bears grudges (not forgiving insults or slights)
    6. Fear of intimacy with sense of vulnerability
    7. Usually isolated and disliked
    8. Often blame others and does not accept criticism
  2. Altered interpretation of illness and physician
    1. Rigid and initiate conflict: may be litigious
    2. Worries that physician may attempt to harm them
  3. Recommended physician approach
    1. Professional stance with clear explanations
    2. Empathic approach to patient's fears
    3. Do not confront paranoia directly
  4. Evaluate for comorbid conditions
    1. Drug Abuse (e.g. Amphetamine abuse)
    2. Obsessive Compulsive Disorder

V. Type: Schizoid Personality

  1. Characteristics
    1. Socially detached and does not enjoy social contact
    2. Chooses solitary activities
    3. Not interested in sex with others
    4. Takes pleasure in few if any activities
    5. Indifferent to praise or criticism from others
    6. Lacks close friends or confidants other than first degree relatives
    7. Anxious when forced into contact with others
    8. Restricted emotional range, flat, cold, humorless, aloof
    9. Often daydream
  2. Altered interpretation of illness and physician
    1. Appear not to appreciate a physician's care
    2. Often wait to pursue medical care
  3. Recommended physician approach
    1. Professional stance with clear explanations
    2. Do not become overly involved in personal issues
  4. Evaluate for comorbid conditions
    1. Not associated with Schizophrenia

VI. Type: Schizotypal Personality

  1. Characteristics
    1. Similar to Schizoid Personality, but also peculiar
    2. Social and interpersonal deficits, isolated
    3. Perceptual distortion and eccentricity
      1. Odd reasoning and speech (vague, stereotyped, overelaborate, circumstantial)
      2. Relates strange experiences
      3. May be superstitious
      4. May believe in clairvoyance, telepathy or a sixth-sense
      5. Children may relate bizarre fantasies or preoccupations
  2. Altered interpretation of illness and physician
    1. Anxious when forced into contact with others
    2. Odd illness interpretation, and odd behavior
    3. Often wait to pursue medical care
  3. Recommended physician approach
    1. Professional stance with clear explanations
    2. Do not become overly involved in personal issues
    3. Do not focus on odd behavior or beliefs
  4. Evaluate for comorbid conditions
    1. Falls on spectrum with Schizophrenia

VII. Management

  1. Target symptoms
    1. Cognitive or perceptual distortion
    2. Interpersonal mistrust
  2. Medications
    1. Atypical Antipsychotic
    2. Consider SSRIs

VIII. References

  1. Tomb (1992) Psychiatry, p. 147-52
  2. (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Washington D.C., APA
  3. Angstman (2011) Am Fam Physician 84(11): 1253-60
  4. Ward (2004) Am Fam Physician 70(8):1505-12

Images: Related links to external sites (from Google)

Ontology: Paranoid Personality Disorder (C0030477)

Definition (NCI) A disorder characterized by an enduring pattern of behavior based on the pervasive belief that the motives of others are malevolent and that they should not be trusted.
Definition (MSH) A personality disorder characterized by the avoidance of accepting deserved blame and an unwarranted view of others as malevolent. The latter is expressed as suspiciousness, hypersensitivity, and mistrust.
Definition (PSY) Nonpsychotic personality disorder marked by hypersensitivity, jealousy, and unwarranted suspicion with tendency to blame others for one's shortcomings.
Concepts Mental or Behavioral Dysfunction (T048)
MSH D010260
ICD9 301.0
ICD10 F60.0
SnomedCT 270529002, 154896003, 13601005, 191750009, 192485008
DSM4 301.0
English Disorder, Paranoid Personality, Disorders, Paranoid Personality, Paranoid Personalities, Paranoid Personality, Paranoid Personality Disorder, Paranoid Personality Disorders, Personalities, Paranoid, Personality Disorder, Paranoid, Personality Disorders, Paranoid, Paranoid personality, Paranoid personality disorder, Personality, Paranoid, PARANOID PERSONALITY DIS, PERSONALITY DIS PARANOID, paranoid personality disorder (diagnosis), paranoid personality disorder, Paranoid personality (& disorder) (disorder), PERSONALITY DISORDER PARANOID, Paranoid personality (disorder), Paranoid Personality Disorder [Disease/Finding], paranoid personality, disorder paranoid personality, paranoid personality disorders, Paranoid personality disorder (disorder), paranoid; personality disorder, paranoid; personality, personality disorder; paranoid, personality; paranoid, Paranoid personality (& disorder), [X]Paranoid personality disorder
Italian Disturbo di personalità paranoide, Personalità paranoide, Disturbo paranoide di personalità
Dutch paranoïde persoonlijkheid, paranoïd; persoonlijkheidsstoornis, paranoïd; persoonlijkheid, persoonlijkheid; paranoïd, persoonlijkheidsstoornis; paranoïd, paranoïde persoonlijkheidsstoornis, Paranoïde persoonlijkheidsstoornis, Persoonlijkheidsstoornis, paranoïde
German paranoide Persoenlichkeit, Paranoide Persoenlichkeitsstoerung, paranoide Persoenlichkeitsstoerung, Paranoide Persönlichkeitsstörung, Persönlichkeitsstörung, paranoide
Portuguese Personalidade paranóide, Perturbação de personalidade paranóide, Transtorno da Personalidade Paranóide
Spanish Personalidad paranoide, Paranoid personality disorder, Paranoid personality, [X]Paranoid personality disorder, Paranoid personality (& disorder), trastorno paranoide de la personalidad (trastorno), trastorno paranoide de la personalidad, Trastorno paranoide de la personalidad, Trastorno de Personalidad Paranoide
Japanese 妄想性人格, モウソウセイジンカク, モウソウセイジンカクショウガイ, 妄想性人格障害, 人格障害-妄想性
Swedish Paranoisk personlighetsstörning
Czech paranoidní porucha osobnosti, Paranoidní porucha osobnosti, Paranoidní osobnost
Finnish Epäluuloinen persoonallisuus
Russian PARANOIDNYE RASSTROISTVA LICHNOSTI, ПАРАНОИДНЫЕ РАССТРОЙСТВА ЛИЧНОСТИ
Korean 편집성 인격 장애
Polish Osobowość paranoiczna
Hungarian Paranoid személyiség zavar, Paranoid személyiség
French Personnalité paranoïde, Personnalité paranoïaque, Trouble de la personnalité de type paranoïaque

Ontology: Eccentric personality disorder (C0338964)

Concepts Mental or Behavioral Dysfunction (T048)
ICD10 F60.89
SnomedCT 191772006, 192493008
Spanish [X]Eccentric personality disorder, trastorno de la personalidad excéntrica (trastorno), trastorno de la personalidad excéntrica, trastorno excéntrico de la personalidad (trastorno), trastorno excéntrico de la personalidad
English eccentric personality, eccentric personality disorder, Eccentric personality disorder, Eccentric personality disorder (disorder), eccentric; personality disorder, personality disorder; eccentric, [X]Eccentric personality disorder, Personality, eccentric
Dutch excentriek; persoonlijkheidsstoornis, persoonlijkheidsstoornis; excentriek