Paranoid schizophrenia, also called schizophrenia, paranoid type is a sub-type of schizophrenia as defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV code 295.30.〔DSM-IV〕 It is the most common type of schizophrenia.〔Varcarolis, Elizabeth. "Psychiatric nursing care plans" 2006〕〔(【引用サイトリンク】 title=Schizophrenia )〕 Schizophrenia is defined as “a chronic mental illness in which a person loses touch with reality (psychosis)."〔Mayo Foundation for Medical Education and Research (2013). Paranoid Schizophrenia. Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/paranoid-schizophrenia/DS00862/DSECTION=symptoms〕 Schizophrenia is divided into subtypes based on the “predominant symptomatology at the time of evaluation."〔Cold Spring Harbor Laboratory. DSM-IV Criteria for Schizophrenia. DNA Learning Center. Retrieved from http://www.dnalc.org/view/899-DSM-IV-Criteria-for-Schizophrenia.html〕 The clinical picture is dominated by relatively stable, often persecutory, delusions, usually accompanied by hallucinations, particularly of the auditory variety (hearing voices), and perceptual disturbances. These symptoms can have a huge effect on functioning and can negatively affect a person’s quality of life. Paranoid schizophrenia is a lifelong illness, but with proper treatment, a person suffering from the illness can live a higher quality of life.〔
Although paranoid schizophrenia is defined by those two symptoms, it is also defined by a lack of certain symptoms (negative symptoms). The following symptoms are not prominent: “disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect."〔 Those symptoms are present in another form of schizophrenia, disorganized-type schizophrenia. The criteria for diagnosing paranoid schizophrenia must be present from at least one to six months.〔 This helps to differentiate schizophrenia from other illnesses, such as bipolar disorder.〔 It also ensures that the illness is chronic and not acute, and will not go away in time.
Paranoid schizophrenia is defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, but it was dropped from the 5th Edition. The American Psychiatric Association chose to eliminate schizophrenia subtypes because they had “limited diagnostic stability, low reliability, and poor validity."〔Grohol, John M. (2013). DSM-V changes: schizophrenia and psychotic disorders. Psych Central. Retrieved from http://pro.psychcentral.com/2013/dsm-5-changes-schizophrenia-psychotic-disorders/004336.html#〕 The symptoms and lack of symptoms that were being used to categorize the different subtypes of schizophrenia were not concrete enough to be able to be diagnosed. The APA also believed that the subtypes of schizophrenia should be removed because “they did not appear to help with providing better targeted treatment, or predicting treatment response."〔 Targeted treatment and treatment response vary from patient to patient, depending on his or her symptoms. It is more beneficial, therefore, to look at the severity of the symptoms when considering treatment options.
== Symptoms ==
Paranoid schizophrenia manifests itself in an array of symptoms. Common symptoms for paranoid schizophrenia include auditory hallucinations (hearing voices) and paranoid delusions (believing everyone is out to cause you harm).〔 However, two of the symptoms separate this form of schizophrenia from other forms.
One criterion for separating paranoid schizophrenia from other types is delusion. A delusion is a belief that is held strong even when the evidence shows otherwise. Some common delusions associated with paranoid schizophrenia include, “believing that the government is monitoring every move you make, or that a co-worker is poisoning your lunch."〔 In all but rare cases, these beliefs are irrational, and can cause the person holding them to behave abnormally. Another frequent type of delusion is a delusion of grandeur, or the “fixed, false belief that one possesses superior qualities such as genius, fame, omnipotence, or wealth."〔Grohol, John M. (2012). Delusion of grandeur. Psych Central. Retrieved from http://psychcentral.com/encyclopedia/2008/delusion-of-grandeur/〕 Common ones include, “the belief that you can fly, that you're famous, or that you have a relationship with a famous person."〔
Another criterion present in patients with paranoid schizophrenia is auditory hallucinations, in which the person hears voices or sounds that are not really present. The patient will sometimes hear multiple voices and the voices can either be talking to the patient or to one another.〔 These voices that the patient hears can influence them to behave in a particular manner. Researchers at the Mayo Foundation for Medical Education and Research provide the following description: “They (voices ) may make ongoing criticisms of what you’re thinking or doing, or make cruel comments about your real or imagined faults. Voices may also command you to do things that can be harmful to yourself or to others."〔 A patient exhibiting these auditory hallucinations may be observed talking to himself because the person believes that the voices are actually present.
Early diagnosis is important for the successful treatment of schizophrenia.
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