Paranoia

**Paranoia**
ICD-10	F20.0, F22.0, F22.8
ICD-9	295.3, 297.1, 297.2
OMIM	{{{OMIM}}}
DiseasesDB	{{{DiseasesDB}}}
MedlinePlus	{{{MedlinePlus}}}
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In popular culture, the term paranoia is usually used to describe excessive concern about one's own well-being, sometimes suggesting a person holds persecutory beliefs concerning a threat to themselves or their property and is often linked to a belief in conspiracy theories.

In psychiatry, the term paranoia was used by Emil Kraepelin to describe a mental illness in which a delusional belief is the sole, or most prominent feature. This usage is now largely obsolete and the term is more typically used in a general sense to signify any delusion, or more specifically, to signify a delusion involving the fear of persecution. The exact use of the term has changed over time, and because of this, psychiatric usage may vary.

Use in psychiatry

In his original attempt at classifying different forms of mental illness, Emil Kraepelin used the term pure paranoia to describe a condition where a delusion was present, but without any apparent deterioration in intellectual abilities and without any of the other features of dementia praecox, the condition later renamed schizophrenia.

In the original Greek, παράνοια (paranoia) means simply madness (para = outside; nous = mind). Kraeplin's developed a definition from this root involving delusional beliefs. Notably, in his definition, the belief does not have to be persecutory to be classified as paranoid, so any number of delusional beliefs can be classified as paranoia. For example, a person who has the sole delusional belief that he is an important religious figure would be classified by Kraepelin as having 'pure paranoia'.

Although the diagnosis of pure paranoia is no longer used (having been superseded by the diagnosis of delusional disorder) the use of the term to signify the presence of delusions in general, rather than persecutory delusions specifically, lives on in the classification of paranoid schizophrenia, which denotes a form of schizophrenia where delusions are prominent.

More recently, the clinical use of the term has been used to describe delusions where the affected person believes they are being persecuted. Specifically, they have been defined as containing two central elements:

The individual thinks that harm is occurring, or is going to occur, to him or her.
The individual thinks that the persecutor has the intention to cause harm.

Paranoia is often associated with psychotic illnesses, particularly schizophrenia, although attenuated features may be present in other primarily non-psychotic diagnoses, such as paranoid personality disorder.

Examples of clinical paranoia

In the unrestricted use of the term, common paranoid delusions can include the belief that the person is being followed, poisoned or loved at a distance (often by a media figure or important person, a delusion known as erotomania or de Clerambault syndrome).

Other common paranoid delusions include the belief that the person has an imaginary disease or parasitic infection (delusional parasitosis); that the person is on a special quest or has been chosen by God; that the person has had thoughts inserted or removed from conscious thought; or that the person's actions are being controlled by an external force.

Many despotic rulers (for example Stalin) allegedly suffered from paranoia. This presents an interesting question because in Stalin's case, it is quite likely that many people really were out to get him (some theories concerning his death hypothesize that he was poisoned). Might it be that with enough enemies, it is impossible not to be clinically paranoid? It still might be possible to identify a paranoid in that situation via his unrealistic assessment of the relative threat presented by various enemies, but it is not clear that non-paranoid persons are all that good at this. This raises interesting philosophical questions about the criteria by which we can diagnose a belief as paranoid or delusional, as well as prompting the joke that "Just because you're paranoid doesn't mean they're not out to get you".

Paranoia depicted in popular culture

In popular culture paranoia is often represented as including:

Belief in having special powers or being on a special mission (a "delusion of grandeur");
Conspiracy theories, such as seeing seemingly unrelated news events as parts of a larger, typically conspiratorial plan
Black helicopters and other mass surveillance
Persecution from powerful adversaries such as UFOs, terrorists, the Men in Black, secret societies or demons
Mind control through invisible rays, and tinfoil hats to combat them;
Fear of poisoning, adulterated food (e.g., aspartame) or water (e.g., fluoridation) as part of a secret plot.
Reading a story, watching a movie, or listening to a song and feeling that one's life is exactly like that of the subject of said story, movie, or song.
The maxim: Just because you're paranoid doesn't mean that they aren't out to get you.

Paranoia

Contents

Use in psychiatry

Examples of clinical paranoia

Paranoia depicted in popular culture

See also

Further reading

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