Paranoid schizophrenia: what is it, symptoms, dangerous?

What is paranoid schizophrenia?

Schizophrenia is a usually chronic mental disorder which is characterized by an erroneous perception of reality, delusions, hallucinations, social and relational isolation, a disorganization of thought and behavior. We are talking about paranoid schizophrenia when delusions are dominated by “paranoia“which basically translates to a feeling of persecution and mistrust permanent vis-à-vis his entourage and unknown people.

What are the symptoms of paranoid schizophrenia?

Paranoid schizophrenia manifests with psychotic symptoms including:

• Of the delusions that do not reflect reality;
• Of the hallucinatory phenomena (hearing things or seeing things that others do not hear or see, voices that persecute me, speak ill of me), perceptions do not exist, they are made by the brain;
• A disorganized thinking and behavior (inappropriate reactions, sudden anger);
• A loss of contact with reality;
• Of the cognitive difficulties : concentration and memory problems, loss of motivation.

► These symptoms are associated with paranoia which is manifested by a permanent feeling of persecution. “The subject is more or less convinced that others (close or not) mean him harm, that they judge him, he interprets all gestures and words negatively. He also feels persecuted by the elements (water, light, extra-terrestrials), things which, a priori, do no harm. Everything can give rise to interpretation, in particular the information heard on television, the patient constructs his own delirium and may have the intuition that a catastrophe is about to occur.

► On an emotional level, the subject is dominated by anguish and fear, he is always on his guard, physically and psychologically tense, tends to withdraw into oneself, adopt avoidance behavior, and can show hostility or even aggression“, develops Professor Anne Sauvaget.

What are the causes of paranoid schizophrenia?

If the exact causes of schizophrenia remain unknown, certain factors would be favorable: a genetic predispositiona disruption of brain neurotransmitters (dopamine), a early infection having affected the brain (toxoplasmosis, flu), regular consumption of cannabis, lack of oxygen (anoxia) during pregnancy or childbirth or even psychosocial stress suffered in childhood.

What are the differences with paranoia?

THE paranoid disorder is a persistent delusional disorder which results in a systematized delirium of mistrust and suspicion towards others, but without disorganization syndrome as in schizophrenia. If the delusion of persecution is more or less present in all forms of schizophrenia, it is much more intense in paranoid schizophrenia.

What to do in the event of a paranoid schizophrenia crisis?

Surroundings plays an essential role in the event of a crisis of paranoid schizophrenia. The priority is to install the patient in a calm environment and talk to him softly to avoid scaring him. It is essential to stay tuned to their needs without imposing himself because he is prey to delusions and hallucinations.

What are the treatments for paranoid schizophrenia?

The treatment is that of schizophrenia. It rests on the combination of drug treatment with atypical antipsychotics aimed at reducing the intensity of the symptoms (persecution and hallucinations) and cognitive behavioral therapy (CBT) to learn to analyze the situation, to understand that no one is really mad at me, to take some distance, manage anxiety with stress management techniques and emotions. In some cases, the transcranial neuromodulation, a cerebral stimulation technique may be recommended.

Is it recognized in ICD10? In the DMS-5?

“The term paranoid schizophrenia was used in old classifications. It is now obsolete and not really used by mental health professionals anymore.says the psychiatrist.

Is it dangerous?

“If the disorder is very intense and the person feels constantly persecuted, he finds himself immersed in a permanent state of hypertension, which is unbearable for her, but also for those around her. Paranoid schizophrenia can lead to reactions of self-aggressiveness and aggressiveness towards those around them but it must be remembered as a priority that most of the time, people suffering from schizophrenia are not dangerous and are above all victims of their disorder and stigma“explains the specialist.

Thanks to Professor Anne Sauvaget, psychiatrist at the University Hospital of Nantes.