Paranoid schizophrenia is a type of schizophrenia where the patient feels that he is being cornered, or plotted against. Read on to know more

Schizophrenia is a serious mental health conditio, and paranoid schizophrenia is a type of schizophrenia. Here, the patient believes that he is being cornered. There is a strong feeling of paranoia, of something going wrong against them. The symptoms might also include hallucinations as well as delusions. It is very important to understand the symptoms of paranoid schizophrenia as early as possible to get the right treatment. Read on to learn more about this condition, why it happens, its symptoms and treatment.

What is paranoid schizophrenia?

Paranoid schizophrenia is a sub-type of schizophrenia, where the patient experiences paranoia. However, the American Psychiatric Association declared the term obsolete in 2013. It now recognises it as one of the symptoms of schizophrenia and lists it under psychosis.

Paranoid schizophrenia is a type of schizophrenia in which individuals experience strong, unfounded beliefs of being cornered or grand plots being planned against them, and they often hear voices that others do not hear. “These experiences are called delusions and auditory hallucinations. People with paranoid schizophrenia might not experience very apparent speech or behaviour issues seen in other forms of schizophrenia, which may allow them to function somewhat better in daily life,” says psychiatrist Dr Ajit Dandekar.

Causes of Paranoid Schizophrenia

Schizophrenia does not have a specific cause. However, several factors can play a role in a person being diagnosed with schizophrenia or paranoid schizophrenia. Here are some of the factors:

1. Chemical imbalances

Imbalances in brain chemistry can also lead to paranoid schizophrenia. The brain uses chemicals to communicate with brain cells, and when there is an imbalance, it can cause a problem. An imbalance between neurotransmitters such as dopamine and serotonin, can cause schizophrenia. A study, published in Frontiers in Psychiatry, lists dopamine as an inhibitory neurotransmitter that is involved in the pathology of schizophrenia. This means that if a patient is diagnosed with schizophrenia, then there would be dopamine abnormalities in the prefrontal regions of the brain.

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2. Genetics

Genetics plays a significant role. It is known that having family members with schizophrenia increases the likelihood of developing the disorder. The NHS lists genetics as one of the biggest reasons behind schizophrenia. Different combinations of genes can add to a person’s chances of getting schizophrenia. However, it should be remembered that it is not certain that gene combination would lead to schizophrenia. For example, in twins, if one has schizophrenia, there is a one in two chance of the other twin also getting it.

3. Differences in brain structure

Differences in brain structure, such as changes in grey matter volume, have also been observed in some patients, says Dr Dandekar. The brain volume alters in schizophrenia, as well as there are structural and functional changes in the cortex, states a study, published in Current Directions in Psychological Science.

4. Environmental factors

Environmental factors such as exposure to viruses or malnutrition during the prenatal period, significant psychosocial stress, and trauma can also trigger symptoms. Other Psychological factors include reactions to acute stress or emotional harm, which can lead to psychotic episodes in vulnerable individuals.

A woman lying down on the bed
Paranoid schizophrenia happens due to chemical imbalances in the brain, as well as genetics. Image courtesy: Freepik

Symptoms of Paranoid Schizophrenia

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition lists the following symptoms

  • Delusions and hallucinations
  • Disorganised speech
  • Disorganised behaviour
  • Diminished emotional expression

It also states that two or more of the symptoms should be present for one month or more. Also, it is important to note that when delusional, people believe in things that are not real, like thinking one is being followed constantly by someone. Hallucinations on the other hand, typically involve hearing voices that do not exist.

How does Paranoid Schizophrenia differ from other forms of Schizophrenia

Paranoid schizophrenia is mainly identified by the symptoms; of delusions and auditory hallucinations. A person does not present any major cognitive decline or emotional distress. However, these symptoms are common in other forms of schizophrenia. This can make it easier for individuals with paranoid schizophrenia to function in everyday life compared to those suffering from other subtypes.

Diagnosis of Paranoid Schizophrenia

Diagnosing paranoid schizophrenia involves a comprehensive psychiatric evaluation to discuss symptoms and mental health history, a medical examination to rule out other conditions, and psychological evaluations using standardized tools.

Mental health professionals use the criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), requiring the presence of symptoms such as delusions, hallucinations, and disorganized speech for a significant portion of time.

A scared woman, holding her head
Antipsychotic drugs are used to control symptoms such as delusions and hallucination. Image courtesy: Freepik

Management and Treatment of Paranoid Schizophrenia

Here are a few ways that schizophrenia can be treated:

  • The management of paranoid schizophrenia involves medication. Antipsychotic drugs are used to control symptoms such as delusions and hallucinations.
  • Psychological interventions, particularly cognitive-behavioural therapy, help individuals cope with the challenges of their condition and reduce the distress caused by their symptoms.
  • Comprehensive care also includes social and vocational skills training to support and improve their community-building skills and quality of life. Often, ongoing treatment and support are required to manage the condition effectively.

What does it mean to be living with someone who has paranoid schizophrenia?

Living with someone who has paranoid schizophrenia requires patience, understanding, and knowledge about the illness. A few things can help:

  • It is crucial to communicate openly, maintain a calm and structured home environment, and establish clear expectations to help manage stress for both the individual and family members.
  • Education about the disorder is vital for understanding the behaviours and symptoms exhibited by a loved one.
  • Professional support for both the patient and family members, including therapy and support groups, is also important.


Paranoid schizophrenia is a very common type of schizophrenia and must be treated as soon as possible. It is essential to follow your treatment plan closely, including medication adherence and attendance at therapy sessions. Managing stress through techniques like meditation, yoga or exercise can help manage the symptoms. Establishing a routine helps provide structure and reduces the unpredictability that can lead to stress. Finally, maintaining social connections and seeking support from peers or support groups can offer comfort and advice, helping to manage the condition more effectively.

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