Often described as a “schizophrenia spectrum personality disorder” but conflicting evidence over whether it should belong to the so called “schizophrenia spectrum”. Some suggest it is closer to delusional disorder than schizophrenia.
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my therapist diagnosed me as a paranoid SZ …but pdoc says delusional disorder…!!
I think it all falls under the umbrella of psychosis.
Paranoid PD is not listed under psychotic disorders in diagnostic manuals although psychosis can occur with it. Same goes for borderline PD.
I would argue there is a need for a “psychotic spectrum” classification incorporating mild/more transient psychotic symptoms through to more more prominent and severe psychotic symptoms.
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From DSM-5: Paranoid personality disorder is a non-psychotic disorder, in that it is a discrete diagnosis involving one’s dysfunctional and maladaptive personality characteristics, rather then a thought or mood disorder.
DSM-5 lists 10 personality disorders (none are on the schizophrenia spectrum), and paranoid personality disorder is in Cluster A.
There is what the diagnostic manuals say and what clinicians say, or believe , with considerable disjoint and conflict/controversy involved.
On a personal level I’m on 25mg Consta with the depot clinic having been quick to chase me up to have it. Last time I hadn’t gone in at my usual time of 1.30. At 1.50 I got a phone call chasing me up for it.
It may not be technically seen as a psychotic disorder by the diagnostic manuals but I suspect nonetheless more than a few of us with the diagnosis are on an AP(depot or oral)
Personally I think the the disjoint between the diagnostic manuals and what pdocs say or do on the ground is problematic.
It certainly raises queries in me as a patient such as " I don’t have a so called psychotic disorder according to the manuals so why do I need it?" vs "If they put me on a depot AP they must believe I need it " and “Would they be so quick to chase me up for it if I didn’t need it?”
Schizotypal (personality) disorder is in the schizophrenia spectrum in the ICD.
For me, the key difference is that a person with paranoid personality disorder is aware (reality based) that they’re paranoid, but a person on the schizophrenia spectrum is not aware when they’re paranoid (out of touch with reality).
That assumes that insight is always impaired in psychosis. I am not sure that is the case. Plenty of posters here have described having delusional thoughts ie they have shown insight about it.
Also plenty have admitted to being paranoid, again showing some level of insight.
From my own experience, insight doesn’t necessarily take away the delusional/paranoiac thoughts. If that was the case would APs be necessary for people with psychosis/schizophrenia? Surely thinking away the delusion/paranoia would suffice if that was the case?
Good point.
Maybe the DSM is splitting hairs, for it’s now nearly 1,000 pages and contains 347 mental disorders.
@firemonkey Theoretically paranoid thoughts are not delusions.
and yet paranoia may stem from a delusion or your paranoia may have a delusional quality to it.
What do you mean by delusional quality?
I think paranoia is a type of delusion (so there is some overlap). I believe delusions may not respond to treatment, but the feeling of paranoia will likely respond to treatment.
Paranoia is found in delusions of persecution and inference.
Example: you believe insects are controlling your brain and become paranoid about it.
Found this interesting re paranoid PD and delusions http://link.springer.com/article/10.1007/s12144-014-9207-8
People with Paranoid Personality Disorder don’t trust anyone!
My psychiatrist was flirting with the idea of personality disorders for me for a while but it was fleeting.
Interesting paper from 2006 on the “psychotic spectrum”.
http://www.jpsychopathol.it/wp-content/uploads/2015/08/Sbrana1.pdf
See also.