Paranoia

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Paranoia
ICD-9 295.3, 297.1, 297.2

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List of terms related to Paranoia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-In-Chief:Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Paranoia is a disturbed thought process characterized by excessive anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs concerning a perceived threat. In the original Greek, παράνοια (paranoia) simply means madness (para = outside; nous = mind) and, historically, this characterization was used to describe any delusional state.

Use in psychiatry

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:

  1. The individual thinks that harm is occurring, or is going to occur, to him or her.
  2. 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. Paranoia can also be a side effect of medication or recreational drugs such as marijuana and particularly stimulants such as methamphetamine.

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.

Therefore, in common usage, the term paranoid addresses a range of mental conditions, assumed by the use of the term to be of psychiatric origin, in which the subject is seen to generalise or project fears and anxieties onto the external world, particularly in the form of organised behaviour focused on them. The syndrome is applied equally to powerful people like executives obsessed with takeover bids or political leaders convinced of plots against them, and to insignificant people who believe for instance that shadowy agencies are operating against them.

History

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. In his original attempt at classifying different forms of mental illness, 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. 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'.

Causes

Common Causes

Causes by Organ System

Cardiovascular Bilateral mesencephalo-thalamic ischaemia
Chemical / poisoning Alcoholism , Cannabis, Cannabis intoxication, Cathinone poisoning , Cocaine addiction , Crystal meth addiction , Ecstasy, Ecstasy addiction , Ecstasy withdrawal , GHB withdrawal, Hawaiian Baby Woodrose poisoning ,Heroin dependence , Levodopa, LSD addiction , Marijuana, Marijuana abuse , Marijuana addiction , Marijuana intoxication, Marijuana overdose , Narcotic addiction , Opioid addiction , Tranquilizer addiction , Wormwood poisoning
Dermatologic No underlying causes
Drug Side Effect Amphetamine Sulfate, Carbidopa, Dopar, Dronabinol, Efavirenz, Marinol, Mazindol, Methyldopa, Methyphenidate, Oxycontin addiction, Pergolide, Prolintane, Ritalin, Sodium oxybate, Substance Withdrawal Syndrome , Thioridazine Hydrochloride
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental ICU psychosis
Gastroenterologic No underlying causes
Genetic Chromosome 22q11 Deletion Spectrum , Down's Syndrome associated Alzheimer's disease , Shprintzen syndorme
Hematologic Acute intermittent porphyria
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal / Ortho No underlying causes
Neurologic Binswanger's disease, Frontotempoal atrophy, Multiple sclerosis, Right parietal lobe syndrome , Wolfram's disease
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Brain tumor
Opthalmologic No underlying causes
Overdose / Toxicity Steroid abuse
Psychiatric ChildhoodOnset Schizophrenia , Delusional disorders, Panic attacks, Paranoid Personality Disorder , Parkinson disease, Psychosis , PTSD, Schizoaffective disorder, Schizoid personality disorder , Schizophrenia , Social phobia
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Lupus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcohol Withdrawal

Causes in Alphabetical Order

See also

Further reading

  • Farrell, John. Paranoia and Modernity: Cervantes to Rousseau (Cornell University Press, 2006).
  • Freeman, D. & Garety, P.A. (2004) Paranoia: The Psychology of Persecutory Delusions. Hove: Psychology Press. ISBN 1-84169-522-X
  • Harper, David J. (1999) Deconstructing Paranoia:An Analysis of the Discourses Associated with the Concept of Paranoid Delusion.
  • Igmade (Stephan Trüby et al, eds.), 5 Codes: Architecture, Paranoia and Risk in Times of Terror", Birkhäuser 2006. ISBN 3-7643-7598-1
  • Kantor, Martin. (2004) Understanding Paranoia: A Guide for Professionals, Families, and Sufferers. Westport: Praeger Press. ISBN 0-275-98152-5
  • Munro, A. (1999) Delusional disorder. Cambridge: Cambridge University Press. ISBN 0-521-58180-X
  • Sims, A. (2002) Symptoms in the mind: An introduction to descriptive psychopathology (3rd edition). Edinburgh: Elsevier Science Ltd. ISBN 0-7020-2627-1
  • Siegel, Ronald K. (1994) Whispers: The Voices of Paranoia. New York: Crown.
  • Deconstructing Paranoia: An Analysis of the Discourses Associated with the Concept of Paranoid Delusion

References

  1. Predescu A, Damsa C, Riegert M, Bumb A, Pull C (2004). "[Persistent psychotic disorder following bilateral mesencephalo-thalamic ischaemia: case report]". Encephale (in French). 30 (4): 404–7. PMID 15538316.
  2. Schep LJ, Knudsen K, Slaughter RJ, Vale JA, Mégarbane B (2012). "The clinical toxicology of gamma-hydroxybutyrate, gamma-butyrolactone and 1,4-butanediol". Clin Toxicol (Phila). 50 (6): 458–70. doi:10.3109/15563650.2012.702218. PMID 22746383. Unknown parameter |month= ignored (help)
  3. Le Page H (2006). "Treatment resistant psychosis in an adolescent with scoliosis and a history of early feeding difficulties". J Can Acad Child Adolesc Psychiatry. 15 (4): 179–81. PMC 2277307. PMID 18392207. Unknown parameter |month= ignored (help)


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