What is Paranoid Schizophrenia?

Schizophrenia is a chronic mental health disorder that affects a large number of people across the world. It is associated with symptoms like hallucinations, delusions, paranoia, and more. Schizophrenia was once classified into multiple sub-types based on the severity of different symptoms associated with it. Paranoid Schizophrenia is one of the subtypes with severe symptoms.

The term was declared obsolete by the American Psychiatric Association in 2013, a stance that other organizations have also taken. Even though the term is outdated, paranoia remains a key symptom that professionals consider when diagnosing and treating schizophrenia.

“Have you ever felt like you were being watched or followed? Imagine feeling that all the time. This paranoia around your daily functioning is one of the main traits of Paranoid Schizophrenia,” says Dr. BR Madhukar, Medical Director, Cadabams Group.

Paranoid schizophrenia was previously a sub-type under Schizophrenia. It is a chronic condition that affects how people think, feel, behave, and relate to themselves and the world.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that one can no longer be diagnosed with ‘Paranoid Schizophrenia.’ However, symptoms of ‘paranoia’ or the ‘positive symptoms’ remain important criteria for diagnosing a person with Schizophrenia.

Who is Affected by Paranoid Schizophrenia?

The condition is not seen to be more common in any gender or other societal group. However, symptoms often appear earlier in men than women. Men are diagnosed with paranoid schizophrenia usually in their early 20s, while women tend to be diagnosed later (late 20s to early 30s). It is important to note that the severity of the symptoms or the disorder is dependent on multiple factors, including genetics, environment, and psychological factors.

How Common is This Condition?

Schizophrenia, as a condition, affects up to 1% of the population of the world. Paranoid schizophrenia, a once-used subtype to denote the prominent symptoms, was considered the most common form of schizophrenia. It is especially distressing due to the increased severity of paranoid symptoms like delusions and hallucinations.

Signs and Symptoms of Paranoid Schizophrenia

The onset of paranoia is not abrupt. It is a gradual change that a person might experience in their perceptions about themselves and the world. Paranoid Schizophrenia symptoms usually entail:

Hearing, seeing, and tasting things that others don’t
Behaving strangely, holding on to unusual beliefs or thoughts
Social Isolation: distancing from friends and family
Lack of personal hygiene or self-care
Not being able to think clearly, pay attention, and function adequately.
Disorganised speech
Being suspicious of others
Feeling as if their thoughts and actions are being controlled by someone else

The above signs persist in people diagnosed with Paranoid Schizophrenia. Usually, a psychotic episode is accompanied by the delusion of persecution and hallucinations.

Delusion of Persecution

It is a false and unfounded belief that individuals or government authorities are out to get them or hurt them. People may experience heightened feelings of Anxiety and fear. Their ability to distinguish the real from the unreal diminishes.

They may start reading too much into people’s everyday behavior. They may also think that what they hear on the radio or television are secret messages directed toward them.

Hallucinations

These are false visual, auditory, olfactory, and tactile perceptions. The most notable of these are auditory hallucinations. People claim to hear voices outside their minds- in external spaces as if somebody is talking to them.

Signs that Immediate Medical Attention is Needed

There are certain situations that can be classified as medical emergencies. These include situations where the person is facing extreme delusions or hallucinations and is completely disconnected from reality. During this period, they may exhibit a tendency to harm themselves or others, necessitating immediate care and medical attention.

Causes and Risk Factors of Schizophrenia

Schizophrenia is a complex disorder influenced by a combination of genetic, medical, biological, and environmental factors.

Genetic Influences

Family History: Having relatives with schizophrenia increases the likelihood of developing the disorder.

Medical Influences

Prenatal Conditions: Inadequate nutrition before birth can heighten the risk.
Infections During Pregnancy: Certain viral infections during pregnancy may contribute to schizophrenia.

Biological Influences

Brain Structure Variations: Abnormalities in brain structure can be associated with schizophrenia.
Neurotransmitter Dysfunction: Issues with neurotransmitters like dopamine can be significant contributors.

Environmental Influences

Stress Factors: High levels of stress can trigger schizophrenia symptoms in at-risk individuals.
Trauma and Abuse History: Previous experiences of trauma or abuse can increase susceptibility.

Cognitive Challenges

Social Cognitive Issues: Social cognitive impairments can appear years before schizophrenia symptoms and may worsen over time.

Impact of Psychoactive Drugs on Paranoid Schizophrenia

Since the 1980s, research has indicated a correlation between the use of psychoactive drugs like marijuana and the development of such disorders. However, little is known about its causality. Whether the use of drugs causes the disorder or if people with Paranoid Schizophrenia use it to self-medicate and cope with the symptoms is debatable.

Research on this topic lacks specificity. Studies highlight that even among heavy cannabis users, only 2.5% exhibit symptoms of paranoid schizophrenia.

Effects of Recreational Drugs

Psychosis Induction: Drugs such as amphetamines, cocaine, cannabis, and LSD can induce psychosis or schizophrenia in susceptible individuals.
Increased Incidence: Substance use is more prevalent among individuals with schizophrenia.
Ambiguous Causality: It is unclear if drug use causes schizophrenia or if schizophrenia leads to increased drug use.
Impact on Treatment: Substance use can disrupt the effectiveness of schizophrenia treatment.

If concerns arise about the use of drugs and the development of psychosis, it is advisable to consult a professional.

Diagnosis of Paranoid Schizophrenia

Diagnosing paranoid schizophrenia requires a comprehensive evaluation by a trained mental health or medical professional, usually a psychiatrist. The diagnosis process involves several steps:

Comprehensive Evaluation

Health and Family History: The psychiatrist will take a detailed health history and family history to identify any genetic predispositions or underlying conditions.
Psychometric Assessments: Various psychometric tests may be used to pinpoint symptoms and aid in diagnosis.
Collaborative Approach: Often, a psychiatrist and a clinical psychologist work together to ensure an accurate diagnosis.

Diagnostic Criteria

For a doctor to diagnose schizophrenia, a person must exhibit continuous symptoms for at least six months. These symptoms may include:

Delusions
Hallucinations
Disorganized Speech
Social and Occupational Dysfunction
Highly Disorganized or Catatonic Behavior
Emotional Flatness or Lack of Pleasure in Everyday Life

A diagnosis can only be made if these symptoms cannot be attributed to other health issues, such as drug or alcohol misuse or mood disorders. Additionally, blood tests and scans may be conducted to rule out physiological conditions that might cause similar symptoms. Overall, reaching a diagnosis can take time, as it requires careful observation and thorough evaluation.

If you have concerns about drug use and the development of psychosis or symptoms suggestive of paranoid schizophrenia, it is crucial to seek professional guidance for accurate diagnosis and effective treatment.

Treatment Options for Paranoid Schizophrenia

Although there is no cure for schizophrenia, treatment focuses on minimizing the symptoms that a person with schizophrenia may experience.

Electroconvulsive Therapy (ECT)

Electroconvulsive Therapy (ECT) is used for those who might be resistant to medication or show catatonic symptoms. This is used as a last resort.

Therapy Sessions

Individuals seeking treatment for paranoid schizophrenia also find it helpful to take regular therapy sessions along with their medication. These sessions help people restructure their thoughts and perceptions, which subsequently brings about a shift in how they might respond in social situations.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a popular approach that has been adopted. It helps teach people with schizophrenia coping strategies and skills that might come in handy to manage symptoms or difficult social situations.

Counselling and Social Support

Counseling and social support are vital for individuals with schizophrenia to achieve independent living. Various therapies, including vocational training and cognitive behavioral therapy, combined with social support systems like peer groups, help improve communication skills, secure employment and housing, and boost overall well-being. Caregivers can play an important role in understanding schizophrenia and supporting treatment adherence.

Medications

To treat schizophrenia with paranoia, mental health professionals typically rely on antipsychotic medications that aim to block dopamine activity in the brain, reducing positive symptoms like delusions and hallucinations. Because schizophrenia affects individuals differently, psychiatrists may experiment with different drug combinations and dosages to manage symptoms effectively. Sometimes, antidepressants or anti-anxiety medications are also used to complement the treatment.

A range of medications are used to manage schizophrenia symptoms, tailored to individual needs. These include oral second-generation antipsychotics (Aripiprazole, Olanzapine, Risperidone, Quetiapine), mood stabilizers (Lithium, Divalproex Sodium), and SSRIs (Fluvoxamine) for depression or anxiety. Depot preparations like Aripiprazole, Paliperidone, and Risperidone help maintain stability after acute symptom management.

Possible Side-Effects of Medication

Antipsychotic drugs may or may not have adverse side effects. Possible side effects include

dry mouth
dizziness
weight gain
diabetes
blurred vision
tardive dyskinesia- the movement of the jaw, lips, and tongue that cannot be controlled.
drowsiness or lack of energy
loss of menstrual periods in women
constipation
sexual problems due to hormonal changes

Severe reactions like blood dyscrasias, sudden death, and neuroleptic malignant syndrome are less common.

Dr. Arun, a consultant psychiatrist at Cadabam’s, notes that “They (families and individuals) sometimes fail to understand that the medication is imperative for an individual to stop their paranoid Schizophrenia symptoms. Stopping the paranoid schizophrenia medications usually leads to relapses.”

The Role of Rehabilitation in Treating Paranoid Schizophrenia

Treatment for paranoid schizophrenia focuses on curbing the intensity of the positive symptoms. However, rehabilitation makes all the difference!

WHO defines rehabilitation as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions."

The rehabilitation process involves social skills training based on an assessment of the individual's strengths. When the individual’s functioning is enhanced, it is natural that their dependence on their caregivers will decrease. It empowers them and improves their agency.

Under the expert supervision of psychiatrists, psychologists, and social workers, rehabilitation makes the transition of the individual- from the clinical setting into society as a functioning member- seamless.

Importance of Daily Routines for Managing Paranoid Schizophrenia

Paranoid schizophrenia is a disorder that significantly disrupts a person’s daily life and habits. A person might have difficulty in spheres including personal hygiene and self-care. Here’s how having daily routines can help a person battling schizophrenia:

Creates Stability: Routines provide a sense of stability, reducing stress and anxiety that can increase the severity of schizophrenia symptoms.
Improves Functioning: They help improve daily functioning and independence by structuring time for self-care, recovery, and medication.
Supports Treatment Compliance: Routines with time set aside for medication management and therapy sessions promote adherence to treatment plans. This is incredibly crucial for managing symptoms of the disorder.
Helps with Symptom Management: Having a regular routine can help caregivers identify symptoms of an episode very early, allowing for treatment to be administered in the initial stages.
Promotes Social Engagement: Structured routines that include social activities can encourage interaction and support from friends and family, fostering a supportive network that is vital for recovery and well-being.

How Effective Family Support and Counseling Can Improve Outcomes in Paranoid Schizophrenia

It is with family and friends that people with paranoid schizophrenia find immense support. However, the physical, psychological, and even economic challenges they face may often be overlooked or not adequately acknowledged.

Delusion of persecution in people with paranoid schizophrenia hurts family members. They feel that they have been wronged- a feeling that may compound itself into unresolved resentment.

Furthermore, psychotic relapses are often perceived by caregivers as a result of their shortcomings. This adds to their stress and evokes a sense of guilt. Caregivers also experience an emotional and economic burden that is often not addressed.

This is where counseling plays an important role. It addresses the emotional needs of the caregivers and realigns their expectations. It assists in restoring the relationship between the caregivers and the patient by helping the caregivers separate the individual from the symptoms.

Finding Hope and Healing for Paranoid Schizophrenia at Cadabam’sCadabam’s have been treating Schizophrenia for over three decades. We understand what it means to watch a loved one fight paranoid schizophrenia. Through our journey to being a leader in mental healthcare, the goal has always been to offer comprehensive help for all disorders.

Moving from place to place, professional to professional, hospital to hospital, while trying to figure out how you can help your loved one is not an experience anyone deserves to go through. That is why we have consolidated all treatment offerings in one place.

Our guarantee to you is that no matter the type of disorder or severity, you will find a treatment option at Cadabams. We are here to help you.

If you are searching for a solution to your problem, Cadabam’s Rehabilitation Centre can help you with its team of specialized experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their Paranoid Schizophrenia. Get in touch with us today. You can call us at +91 96111 94949

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FAQs

1. What are the Signs that Immediate Medical Attention is Needed?

Schizophrenia is a disorder that can cause medical emergencies. Signs that emergency help is needed include severe hallucinations or delusions that can cause a person to harm themselves or those around them.

2. How Does Paranoid Schizophrenia Affect Daily Life?

Paranoid schizophrenia disrupts a person’s daily life completely. It affects their personal hygiene, their academic life, professional life, and personal relationships as well. It can also cause them to become a danger to themselves or those around them.

3. How is Paranoid Schizophrenia Diagnosed?

Paranoid schizophrenia is diagnosed through a combination of psychiatric interviews and psychometric assessments. Certain diagnostic tests and scans are also used to rule out other physiological conditions.

4. Can a paranoid schizophrenic live a normal life?

Yes, with proper treatment and support, individuals with paranoid schizophrenia can lead fulfilling lives. Adhering to medication therapy and maintaining a structured routine are key to managing symptoms and improving quality of life.

5. What Treatment Options are Available for Paranoid Schizophrenia?

Treatment includes antipsychotic medications, mood stabilizers, SSRIs, therapy sessions, Cognitive Behavioral Therapy (CBT), and sometimes Electroconvulsive Therapy (ECT) for those resistant to medication.