Signs and symptoms of paranoid schizophrenia

Signs and symptoms of paranoid schizophreniaMany people with schizophrenia have paranoia, which makes them overly distrustful. Early symptoms may include delusions, hallucinations, and other symptoms.

Paranoia is a pattern of thinking in which one feels irrationally suspicious, persecuted or threatened. It can range from mild feelings of unease to an intense, extremely distressing and disabling thought pattern.

For people with schizophrenia, the experience of paranoia can be persistent, extremely uncomfortable, and even dangerous.

Until 2013, schizophrenia was classified into several subtypes, paranoid schizophrenia being one of them. It is no longer considered a definitive subtype of the disorder, so the term paranoid schizophrenia is officially incorrect. However, paranoia is a common symptom of schizophrenia, so it could be called schizophrenia with paranoia.1

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Common symptoms

For people with schizophrenia with paranoia, reality may be unclear. For example, in addition to their paranoia, they may see people and hear voices that they believe are real but are not. As you can imagine, this can interfere with a person's ability to lead a normal life.

Examples of early symptoms that may be a prodromal for the onset of schizophrenia with paranoia include:2:

– Avoidance of social events and interactions

– Irritability

– Problems at work or school

– Increase in motivational problems

– Problems focusing or paying attention

Other signs of schizophrenia with paranoia are common:

– Seeing things that others do not see

– Hearing voices that are not there

– General anxiety related to the intent of others (paranoia about being poisoned is a common fear)

– Distrust

– Running, bizarre or unusual thoughts or beliefs

– Problems thinking clearly

– Social isolation

– A decline in general hygiene or other aspects of self-care

Phases of schizophrenia

There are several phases of schizophrenia as the illness progresses from the early warning signs, called the prodromal phase, to the active phase of the illness, when perceptual disturbances and debilitating thoughts are present.

These symptoms do not necessarily indicate that a person has schizophrenia with paranoia, but the presence of symptoms warrants an evaluation by a psychologist.

Early intervention often means better treatment outcomes for people diagnosed with schizophrenia with paranoia.


Delusions are decidedly untrue beliefs; these beliefs are maintained despite evidence to the contrary. Examples of common types of delusions that people with schizophrenia may have include:

– Delusions of grandeur: believing that one has special talents or gifts, immense wealth, or other important qualities

– Delusions of control: thinking that one is being controlled by entities such as aliens, the government, voices from television, or other outside forces

– Delusions of persecution: the belief that one or more people are conspiring against you or a loved one, trying to harm you, or otherwise mistreating you

– Delusions of reference: the false belief that an unrelated event has a direct relationship to oneself

Approximately 90% of people diagnosed with schizophrenia have some type of delusion

Although not all delusions are the same, some people have some commonalities. For example, believing another person is poisoning food or drink is a common deception of pursuit.


There are several types of hallucinations, including:4

– Visual hallucinations: Seeing something that is not real or does not exist

– Auditory hallucinations: Perception of sounds that are not present, such as perceived voices

– Olfactory or gustatory hallucinations: Smelling scents or odors and tasting tastes that do not exist; usually the scents are unpleasant

– Tactile hallucination: the sensation of being touched, z. B. Having something crawling on the skin when it is not occurring

Voices may be: 5

– Male or female

– A familiar or unfamiliar person

– Sounds instead of human voices, such as a buzzing noise

– Spoken by a person with a foreign accent

– Spoken in a whispering voice or by shouting

– Negative and disturbing

– Ongoing or intermittent

– More than one voice

– Commenting or criticizing

– Giving orders

Disorganized speech

People with schizophrenia may have a symptom called disorganized speech. This does not mean a speech impairment; rather, it is speech that is derailed or incoherent. It may include repeating words and phrases or speaking in the middle of a sentence instead of at the beginning.

This symptom stems from disorganized thinking that people with schizophrenia often have. Sometimes this type of speech is referred to as word salad.

Disorganized behavior

Disorganized behavior is the general inability to control external behavior, including emotions and impulses.

Examples of how disorganized behavior may manifest in a person with schizophrenia with paranoia include:

– Difficulty performing daily activities

– Abnormal movements or lack of exercise

– Problems with impulse control

– Problems controlling emotions

– Difficulty containing actions that are deemed inappropriate or strange

Disorganized behavior can have a major negative impact on a person's work, education, and home life, and can affect personal relationships.

Suicidal thoughts

Suicidal thoughts and attempts are at increased risk in people with schizophrenia with paranoia. Suicidal ideation is more common in people with untreated schizophrenia with paranoia.6

Seeking help

If you or someone you know is having thoughts of self-harm, contact the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment services near you.


Many co-occurring disorders often affect a person with schizophrenia with paranoia. For example, people with schizophrenia often use alcohol or illegal drugs to treat their symptoms. Another complication is the development of concurrent mood and anxiety disorders.

Additional complications of schizophrenia may include:

– Nicotine addiction

– Financial problems

– Loss of employment

– Homelessness

– Suicide

When to see a doctor

If a person with schizophrenia is contemplating suicide, and specifically admits to having formulated a suicide plan, it is of the utmost importance to seek emergency medical help immediately.

There are many suicide crisis lines that can be reached via a phone call, available 24/7. Among them are:

– Call 911 (for emergency medical care or go to the emergency room of the nearest hospital)

– National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text the Crisis Text Line (HELLO to 741741)


A person with schizophrenia usually seeks treatment during the active phase of the illness. This is when the positive symptoms of psychosis (such as hallucinations) appear and cause a significant disruption in a person's life.7 Below is a selection of the effective treatments available to treat these symptoms.

Antipsychotic medications

Antipsychotics are perhaps the most common form of treatment for people with schizophrenia with paranoia. These medicines work to reduce or eliminate psychosis such as hallucinations and delusions.

Antipsychotics can be administered:

– Every day with the mouth

– In pill or liquid form

– Every few weeks as an injectable form (which is the preferred route of administration for those who do not comply with their medications)

Difficulty in administering medication

People with schizophrenia with paranoia often have delusional thinking that includes the belief that they are being poisoned. This can lead to noncompliance with taking medications.

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