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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Individuals experiencing religious delusions are preoccupied with religious subjects that are not within the expected beliefs for an individual's background, including culture, education, and known experiences of religion. These preoccupations are incongruous with the mood of the subject. Falling within the definition also are delusions arising in psychotic depression; however, these must present within a major depressive episode and be congruous with mood.
Researchers in a 2000 study found religious delusions to be unrelated to any specific set of diagnostic criteria, but correlated with demographic criteria, primarily age. In a comparative study sampling 313 patients, those with religious delusion were found to be aged older, and had been placed on a drug regime or started a treatment programme at an earlier stage. In the context of presentation, their global functioning was found to be worse than another group of patients without religious delusions. The first group also scored higher on the Scale for the Assessment of Positive Symptoms (SAPS), had a greater total on the Brief Psychiatric Rating Scale (BPRS), and were treated with a higher mean number of neuroleptic medications of differing types during their hospitalization.
Religious delusion was found in 2007 to strongly correlate with "temporolimbic overactivity". This is a condition where irregularities in the brain's limbic system may present as symptoms of paranoid schizophrenia.
In a 2010 study, Swiss psychiatrists found religious delusions with themes of spiritual persecution by malevolent spirit-entities, control exerted over the person by spirit-entities, delusional experience of sin and guilt, or delusions of grandeur.
Religious delusions have generally been found to be less stressful than other types of delusion. A study found adherents to new religious movements to have similar delusionary cognition, as rated by the Delusions Inventory, to a psychotic group, although the former reported feeling less distressed by their experiences than the latter.
In addition to these categories, delusions often manifest according to a consistent theme. Although delusions can have any theme, certain themes are more common. Some of the more common delusion themes are:
- Delusion of control: False belief that another person, group of people, or external force controls one's general thoughts, feelings, impulses, or behavior.
- Cotard delusion: False belief that one does not exist or has died.
- Delusional jealousy: False belief that a spouse or lover is having an affair, with no proof to back up their claim.
- Delusion of guilt or sin (or delusion of self-accusation): Ungrounded feeling of remorse or guilt of delusional intensity.
- Delusion of mind being read: False belief that other people can know one's thoughts.
- Delusion of thought insertion: Belief that another thinks through the mind of the person.
- Delusion of reference: False belief that insignificant remarks, events, or objects in one's environment have personal meaning or significance.
- Erotomania: False belief that another person is in love with them.
- Grandiose religious delusion: Belief that the affected person is a god or chosen to act as a god.
- Somatic delusion: Delusion whose content pertains to bodily functioning, bodily sensations or physical appearance. Usually the false belief is that the body is somehow diseased, abnormal or changed. A specific example of this delusion is delusional parasitosis: Delusion in which one feels infested with insects, bacteria, mites, spiders, lice, fleas, worms, or other organisms. Affected individuals may also report being repeatedly bitten. In some cases, entomologists are asked to investigate cases of mysterious bites. Sometimes physical manifestations may occur including skin lesions.
- Delusion of poverty: Person strongly believes they are financially incapacitated. Although this type of delusion is less common now, it was particularly widespread in the days preceding state support.
Grandiose delusions or delusions of grandeur are principally a subtype of delusional disorder but could possibly feature as a symptom of schizophrenia and manic episodes of bipolar disorder. Grandiose delusions are characterized by fantastical beliefs that one is famous, omnipotent or otherwise very powerful. The delusions are generally fantastic, often with a supernatural, science-fictional, or religious bent. In colloquial usage, one who overestimates one's own abilities, talents, stature or situation is sometimes said to have "delusions of grandeur". This is generally due to excessive pride, rather than any actual delusions. Grandiose delusions or delusions of grandeur can also be associated with megalomania.
A religious delusion is any delusion involving religious themes or subject matter. Though a small minority of psychologists have characterized all or nearly all religion as delusion, others focus solely on a denial of any spiritual cause of symptoms exhibited by a patient and look for other answers relating to a chemical imbalance in the brain, although there is actually no evidence of pathology in any psychiatric illness which means a diagnosis is made purely on opinions of professionals based on symptoms the person exhibits.
A popular symptom of paranoia is the attribution bias. These individuals typically have a biased perception of reality, often exhibiting more hostile beliefs. A paranoid person may view someone else's accidental behavior as though it is with intent or threatening.
An investigation of a non-clinical paranoid population found that feeling powerless and depressed, isolating oneself, and relinquishing activities are characteristics that could be associated with those exhibiting more frequent paranoia.
Some scientists have created different subtypes for the various symptoms of paranoia including erotic, persecutory, litigious, and exalted.
Due to the suspicious and troublesome personality traits of paranoia, it is unlikely that someone with paranoia will thrive in interpersonal relationships. Most commonly paranoid individuals tend to be of a single status. According to some research there is a hierarchy for paranoia. The least common types of paranoia at the very top of the hierarchy would be those involving more serious threats. Social anxiety is at the bottom of this hierarchy as the most frequently exhibited level of paranoia.
Persecutory delusions are the most common type of delusions and involve the theme of being followed, harassed, cheated, poisoned or drugged, conspired against, spied on, attacked, or otherwise obstructed in the pursuit of goals.
Persecutory delusions are a condition in which the affected person wrongly believes that they are being persecuted. Specifically, they have been defined as containing three central elements: The individual thinks that:
1. harm is occurring, or is going to occur.
2. the persecutor(s) has(have) the intention to cause harm.
3. they are constantly being prejudged or profiled.
According to the DSM-IV-TR, persecutory delusions are the most common form of delusions in schizophrenia, where the person believes they are "being tormented, followed, sabotaged, tricked, spied on, or ridiculed." In the DSM-IV-TR, persecutory delusions are the main feature of the persecutory type of delusional disorder. When the focus is to remedy some injustice by legal action, they are sometimes called "querulous paranoia".
According to the DSM-IV-TR diagnostic criteria for delusional disorders, grandiose-type symptoms include grossly exaggerated beliefs of:
- self-worth
- power
- knowledge
- identity
- exceptional relationship to a divinity or famous person.
For example, a patient who has fictitious beliefs about his or her power or authority may believe himself or herself to be a ruling monarch who deserves to be treated like royalty.
There are substantial differences in the degree of grandiosity linked with grandiose delusions in different patients. Some patients believe they are God, the Queen of England, a president's son, a famous rock star, and so on. Others are not as expansive and think they are skilled sports-persons or great inventors.
Paranoia is an instinct or thought process believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory, or beliefs of concerning a perceived threat towards oneself (e.g. ""Everyone is out to get me"", which is an American parochial phrase). Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame. Making false accusations and the general distrust of others also frequently accompany paranoia. For example, an incident most people would view as an accident or coincidence, a paranoid person might believe was intentional. Paranoia is a central symptom of psychosis. It is also a matter of personal tolerance for the individual that might be in conflict with psychiatric diagnoses.
Research suggests that the severity of the delusions of grandeur is directly related to a higher self-esteem in individuals and inversely related to any individual’s severity of depression and negative self-evaluations. Lucas "et al." found that there is no significant gender difference in the establishment of grandiose delusion. However, there is a claim that ‘the particular component of Grandiose delusion’ may be variable across both genders. Also, it had been noted that the presence of GDs in people with at least grammar or high school education was greater than lesser educated persons. Similarly, the presence of grandiose delusions in individuals who are the eldest is greater than in individuals who are the youngest of their siblings.
Diagnosis of a specific type of delusional disorder can sometimes be made based on the content of the delusions. The "Diagnostic and Statistical Manual of Mental Disorders" (DSM) enumerates seven types:
- Erotomanic type (erotomania): delusion that another person, often a prominent figure, is in love with the individual. The individual may breach the law as he/she tries to obsessively make contact with the desired person.
- Grandiose type: delusion of inflated worth, power, knowledge, identity or believes themself to be a famous person, claiming the actual person is an impostor or an impersonator.
- Jealous type: delusion that the individual's sexual partner is unfaithful when it is untrue. The patient may follow the partner, check text messages, emails, phone calls etc. in an attempt to find "evidence" of the infidelity.
- Persecutory type: This delusion is a common subtype. It includes the belief that the person (or someone to whom the person is close) is being malevolently treated in some way. The patient may believe that he/she has been drugged, spied upon, harassed and so on and may seek "justice" by making police reports, taking court action or even acting violently.
- Somatic type: delusions that the person has some physical defect or general medical condition
- Mixed type: delusions with characteristics of more than one of the above types but with no one theme predominating.
- Unspecified type: delusions that cannot be clearly determined or characterized in any of the categories in the specific types.
The following can indicate a delusion:
1. The patient expresses an idea or belief with unusual persistence or force.
2. That idea appears to have an undue influence on the patient's life, and the way of life is often altered to an inexplicable extent.
3. Despite his/her profound conviction, there is often a quality of secretiveness or suspicion when the patient is questioned about it.
4. The individual tends to be humorless and oversensitive, especially about the belief.
5. There is a quality of "centrality": no matter how unlikely it is that these strange things are happening to him/her, the patient accepts them relatively unquestioningly.
6. An attempt to contradict the belief is likely to arouse an inappropriately strong emotional reaction, often with irritability and hostility.
7. The belief is, at the least, unlikely, and out of keeping with the patient's social, cultural, and religious background.
8. The patient is emotionally over-invested in the idea and it overwhelms other elements of their psyche.
9. The delusion, if acted out, often leads to behaviors which are abnormal and/or out of character, although perhaps understandable in the light of the delusional beliefs.
10. Individuals who know the patient observe that the belief and behavior are uncharacteristic and alien.
Additional features of delusional disorder include the following:
1. It is a primary disorder.
2. It is a stable disorder characterized by the presence of delusions to which the patient clings with extraordinary tenacity.
3. The illness is chronic and frequently lifelong.
4. The delusions are logically constructed and internally consistent.
5. The delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is usually no general disturbance of behavior. If disturbed behavior does occur, it is directly related to the delusional beliefs.
6. The individual experiences a heightened sense of self-reference. Events which, to others, are nonsignificant are of enormous significance to him or her, and the atmosphere surrounding the delusions is highly charged.
Clinical lycanthropy is defined as a rare psychiatric syndrome that involves a delusion that the affected person can transform into, has transformed into, or is a non-human animal. Its name is associated with the mythical condition of lycanthropy, a supernatural affliction in which humans are said to physically shapeshift into wolves. It is purported to be a rare disorder.
Grandiosity refers to an unrealistic sense of superiority—a sustained view of oneself as better than others that causes the narcissist to view others with disdain or as inferior—as well as to a sense of uniqueness: the belief that few others have anything in common with oneself and that one can only be understood by a few or very special people. It also occurs in reactive attachment disorder.
Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder.
Ideas of reference and delusions of reference describe the phenomenon of an individual's experiencing innocuous events or mere coincidences and believing they have strong personal significance. It is "the notion that everything one perceives in the world relates to one's own destiny".
In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia, delusional disorder, bipolar disorder (during the elevated stages of mania), as well as schizotypal personality disorder. To a lesser extent, it can be a hallmark of paranoid personality disorder. Such symptoms can also be caused by intoxication, especially with hallucinogens or stimulants like methamphetamine.
The delusions that fall under this category are:
- Capgras delusion: the belief that (usually) a close relative or spouse has been replaced by an identical-looking impostor.
- Fregoli delusion: the belief that various people whom the believer meets are actually the same person in disguise.
- Intermetamorphosis: the belief that people in one's environment swap identities with each other while maintaining the same appearance.
- Subjective doubles: a person believes there is a doppelgänger or double of him- or herself carrying out independent actions.
- Cotard delusion: the belief that oneself is dead or does not exist; sometimes coupled with the belief that one is putrefying or missing internal organs.
- Mirrored-self misidentification: the belief that one's reflection in a mirror is some other person.
- Reduplicative paramnesia: the belief that a familiar person, place, object, or body part has been duplicated. For example, a person may believe that they are, in fact, not in the hospital to which they were admitted, but in an identical-looking hospital in a different part of the country.
- Somatoparaphrenia: the delusion where one denies ownership of a limb or an entire side of one's body (often connected with stroke).
Note that some of these delusions are sometimes grouped under the umbrella term of delusional misidentification syndrome.
A fixed fantasy — also known as a "dysfunctional schema" — is a belief or system of beliefs held by a single individual to be genuine, but that cannot be verified in reality. The term is typically applied to individuals suffering from some type of psychiatric dysregulation, most often a personality disorder.
The term is also used in the different context of psychoanalysis to distinguish between 'a normal transitory one and a fixed fantasy' with respect to the phantasised 'fulfilment in conscious or unconscious thought of the sexualised wish'.
Affected individuals believe that they are in the process of transforming into an animal or have already transformed into an animal. It has been associated with the altered states of mind that accompany psychosis (the that typically involves delusions and hallucinations) with the transformation only seeming to happen in the mind and behavior of the affected person.
A study on lycanthropy from the McLean Hospital reported on a series of cases and proposed some diagnostic criteria by which lycanthropy could be recognised:
- A patient reports in a moment of lucidity or reminiscence that they sometimes feel as an animal or have felt like one.
- A patient behaves in a manner that resembles animal behavior, for example howling, growling, or crawling.
According to this criteria, either a delusional belief in current or past transformation or behavior that suggests a person thinks of themselves as transformed is considered evidence of clinical lycanthropy. The authors note that, although the condition seems to be an expression of psychosis, there is no specific diagnosis of mental or neurological illness associated with its behavioral consequences.
DSM-IV Criteria
Clinical Lycanthropy is thought to be a cultural manifestation of schizophrenia due to the first 4 symptomatic criteria. The first criteria are delusions, and this fits clinical lycanthropy because a person believing that he or she turns into an animal is a delusion. The second symptom is hallucination, and people with clinical lycanthropy have vivid hallucinations of being an animal, and having traits that animal has, whether it be claws, fur, fangs, or whatever that particular animal has. The next symptom is disorganized speech, from a certain human, cultural perspective. The people who have the diagnosis of clinical lycanthropy often emit the sounds of the animal which they believe they become. So, if a person believes that he or she is a werewolf, they may begin to howl under the moon or sometimes even in the daylight. The last symptom that matches schizophrenia is grossly disorganized behavior. This is appropriate because individuals with clinical lycanthropy often act like the animal they believe they have become, including living outside and changing their diet.
It also seems that lycanthropy is not specific to an experience of human-to-wolf transformation; a wide variety of creatures have been reported as part of the shape-shifting experience. A review of the medical literature from early 2004 lists over thirty published cases of lycanthropy, only the minority of which have wolf or dog themes. Canines are certainly not uncommon, although the experience of being transformed into a hyena, cat, horse, bird or tiger has been reported on more than one occasion. Transformation into frogs, and even bees, has been reported in some instances. In Japan, transformation into foxes and dogs was usual (, ). A 1989 case study described how one individual reported a serial transformation, experiencing a change from human to dog, to horse, and then finally cat, before returning to the reality of human existence after treatment. There are also reports of people who experienced transformation into an animal only listed as "unspecified".
There is a case study of a psychiatric patient who had both clinical lycanthropy and Cotard delusion. The term "ophidianthropy" refers to the delusion that one has been transformed into a snake. Two case studies have been reported.
A monothematic delusion is a delusional state that concerns only one particular topic. This is contrasted by what is sometimes called "multi-thematic" or "polythematic" delusions where the person has a range of delusions (typically the case of schizophrenia). These disorders can occur within the context of schizophrenia or dementia or they can occur without any other signs of mental illness. When these disorders are found outside the context of mental illness, they are often caused by organic dysfunction as a result of traumatic brain injury, stroke, or neurological illness.
People who experience these delusions as a result of organic dysfunction often do not have any obvious intellectual deficiency nor do they have any other symptoms. Additionally, a few of these people even have some awareness that their beliefs are bizarre, yet they cannot be persuaded that their beliefs are false.
Paranoid personality disorder (PPD) is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. Individuals with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence.
They tend to be guarded and suspicious and have quite constricted emotional lives. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience. People with PPD may have a tendency to bear grudges, suspiciousness, tendency to interpret others' actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right. Patients with this disorder can also have significant comorbidity with other personality disorders.
The core symptom of the disorder is that the sufferer holds an unshakable belief that another person is secretly in love with them. In some cases, the sufferer may believe several people at once are "secret admirers". The sufferer may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates his or her love by subtle methods such as body posture, arrangement of household objects, and other seemingly innocuous acts (or, if the person is a public figure, through clues in the media). Erotomanic delusions are typically found as the primary symptom of a delusional disorder or in the context of schizophrenia and may be treated with atypical antipsychotics.
Erotomania is a type of delusional disorder where the affected person believes that another person is in love with him or her. This belief is usually applied to someone with higher status or a famous person, but can also be applied to a complete stranger. Erotomanic delusions often occur in patients with schizophrenia and other psychotic disorders, but can also occur during a manic episode in the context of bipolar I disorder. During an erotomanic delusion, the patient believes that a secret admirer is declaring his or her affection for the patient, often by special glances, signals, telepathy, or messages through the media. Usually the patient then returns the perceived affection by means of letters, phone calls, gifts, and visits to the unwitting recipient. Even though these advances are unexpected and often unwanted, any denial of affection by the object of this delusional love is dismissed by the patient as a ploy to conceal the forbidden love from the rest of the world.
Erotomania is also called de Clérambault's syndrome, after French psychiatrist Gaëtan Gatian de Clérambault (1872–1934), who published a comprehensive review paper on the subject ("Les Psychoses Passionnelles") in 1921. Erotomania should not be confused with obsessive love or obsession with unrequited love, neither of which involves delusion.
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 the sufferer 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 strongly 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." 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 can influence the patient to behave in a particular manner. Researchers at the Mayo Foundation for Medical Education and Research provide the following description: “They [the 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 them" because the person believes that the voices represent people who are present.
Early diagnosis is critical for the successful treatment of schizophrenia.
Delusional misidentification syndrome is an umbrella term, introduced by Christodoulou (in his book "The Delusional Misidentification Syndromes", Karger, Basel, 1986) for a group of delusional disorders that occur in the context of mental and neurological illness. They all involve a belief that the identity of a person, object, or place has somehow changed or has been altered. As these delusions typically only concern one particular topic, they also fall under the category called monothematic delusions.
This psychopathological syndrome is usually considered to include four main variants:
- The Capgras delusion is the belief that (usually) a close relative or spouse has been replaced by an identical-looking impostor.
- The Fregoli delusion is the belief that various people the believer meets are actually the same person in disguise.
- Intermetamorphosis is the belief that people in the environment swap identities with each other whilst maintaining the same appearance.
- Subjective doubles, described by Christodoulou in 1978 ("American Journal of Psychiatry" 135, 249, 1978), is the belief that there is a doppelgänger or double of him- or herself carrying out independent actions.
However, similar delusional beliefs, often singularly or more rarely reported, are sometimes also considered to be part of the delusional misidentification syndrome. For example:
- Mirrored-self misidentification is the belief that one's reflection in a mirror is some other person.
- Reduplicative paramnesia is the belief that a familiar person, place, object, or body part has been duplicated. For example, a person may believe that they are in fact not in the hospital to which they were admitted, but an identical-looking hospital in a different part of the country, despite this being obviously false.
- The Cotard delusion is a rare disorder in which people hold a delusional belief that they are dead (either figuratively or literally), do not exist, are putrefying, or have lost their blood or internal organs. In rare instances, it can include delusions of immortality.
- Syndrome of delusional companions is the belief that objects (such as soft toys) are sentient beings.
- Clonal pluralization of the self, where a person believes there are multiple copies of him- or herself, identical both physically and psychologically but physically separate and distinct.
There is considerable evidence that disorders such as the Capgras or Fregoli syndromes are associated with disorders of face perception and recognition. However, it has been suggested that all misidentification problems exist on a continuum of anomalies of familiarity, from déjà vu at one end to the formation of delusional beliefs at the other.
Chronic hallucinatory psychosis is a psychosis subtype, classified under "Other nonorganic psychosis" by the . Other abnormal mental symptoms in the early stages are, as a rule, absent. The patient is most usually quiet and orderly, with a good memory.
It has often been a matter of the greatest difficulty to decide under which heading of the recognized classifications individual members of this group should be placed. As the hallucinations give rise to slight depression, some might possibly be included under melancholia. In others, paranoia may develop. Others, again, might be swept into the widespread net of dementia praecox. This state of affairs cannot be regarded as satisfactory, for they are not truly cases of melancholia, paranoia, dementia praecox or any other described affection.
This disease, as its name suggests, is a hallucinatory case, for it is its main feature. These may be of all senses, but auditory hallucinations are the most prominent. At the beginning, the patient may realize that the hallucination is a morbid phenomenon and unaccountable. They may claim to hear a "voice" speaking, though there is no one in the flesh actually doing so. Such a state of affairs may last for years and possibly, though rarely, for life, and the subject would not be deemed insane in the ordinary sense of the word.
It's probable, however, that this condition forms the first stage of the illness, which eventually develops on definite lines. What usually happens is the patient seeks an explanation for the hallucinations. As none is forthcoming he/she tries to account for their presence and the result is a delusion, and, most frequently, a delusion of persecution. Also, it needs to be noted that the delusion is a comparatively late arrival and is the logical result of the hallucinations.
The article "Betwixt Life and Death: Case Studies of the Cotard Delusion" (1996) describes a contemporary case of Cotard delusion, which occurred in a Scotsman whose brain was damaged in a motorcycle accident:
The article "Recurrent Postictal Depression with Cotard Delusion" (2005) describes the case of a fourteen-year-old epileptic boy whose distorted perception of reality resulted from Cotard syndrome. His mental health history was of a boy expressing themes of death, chronic sadness, decreased physical activity in playtime, social withdrawal, and disturbed biological functions. About twice a year, the boy suffered episodes that lasted between three weeks and three months. In the course of each episode, he said that everyone and everything was dead (including trees), described himself as a dead body, and warned that the world would be destroyed within hours. Throughout the episode, the boy showed no response to pleasurable stimuli and had no interest in social activities.
Paranoid schizophrenia is the most common type of schizophrenia. Schizophrenia is defined as “a chronic mental disorder in which a person loses touch with reality (psychosis)." Schizophrenia is divided into subtypes based on the “predominant symptomatology at the time of evaluation." The clinical picture is dominated by relatively stable and often persecutory delusions that are 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 quality of life. Paranoid schizophrenia is a lifelong disease, but with proper treatment, a person with the illness can attain 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 and 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 mental disorders, such as bipolar disorder.
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 (APA) chose to eliminate schizophrenia subtypes because they had “limited diagnostic stability, low reliability, and poor validity." 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.