People with a paranoid type of schizophrenia hear voices and have delusions of persecution. The voices are usually related to delusions that others are plotting against them or people close to them. Paranoid schizophrenia is often the least difficult form of the disease to treat. It is also easier to predict how well a patient will fare with this form of schizophrenia compared to other subtypes. Symptoms tend to appear later than in other forms; the age at diagnosis tends toward the mid-thirties instead of early adulthood.
People with pure paranoid schizophrenia have no negative symptoms, can speak coherently with no sign of disorganized speech, and demonstrate no catatonic behavior, that is, immobility or repetitive movements.
A successful interview will reveal a delusion of persecution. Except for their delusions and the voices they hear, people suffering from paranoid schizophrenia can be difficult to distinguish from anyone else. They can maintain a pleasant appearance and take care of themselves. This often allows them to hold on to their jobs and function in society much more successfully than do people suffering from other forms of the disease. It also raises the question of whether paranoid schizophrenia is a distinct disease.
A Patient with Paranoid Schizophrenia
Meets general criteria for schizophrenia
Hears voices frequently (auditory delusions) or is convinced she is being persecuted or plotted against
Demonstrates no disorganized speech or behavior
Shows no sign of inappropriate or unexpressive emotional response (flat affect)
Shows no sign of catatonia (bizarre behavior, odd postures, excited or excessively subdued behavior)
Adapted from the DSM-IV.