Paranoid Schizophrenia
"They are playing a game. They are playing at not playing a game. If I show them I see they are, I shall break the rules and they will punish me. I must play their game, of not seeing I see the game."

R.D. Laing. Knots.

Defined in the DSMiv as:

A type of schizophrenia in which there are:

1. Preoccupation with one or more systematized delusions or with frequent auditory hallucinations related to a single theme.

2. None of the following: incoherence, marked loosening of associations, flat or grossly inappropriate affect, catatonic behaviour, grossly disorganized behaviour.

The essential feature of Paranoid Schizophrenia is preoccupation with one or more systematized delusions or with frequent auditory hallucinations related to a single theme. In addition, symptoms characteristic of the Disorganized and Catatonic Types such as incoherence, flat or grossly inappropriate affect, catatonic behaviour, or grossly disorganized behaviour, are absent. When all exacerbations of the disorder meet the criteria for Paranoid Type, the clinician should specify "Stable Type".

Associated features of Paranoid Schizophrenia include unfocussed anxiety, anger, argumentativeness, and violence. Often a stilted, formal quality or extreme intensity in interpersonal interaction is noted.

The impairment in functioning in Paranoid Schizophrenia may be minimal if the delusional material is not acted upon. Onset tends to be later in life than the other types, and the distinguishing characteristics may be more stable over time. Some evidence suggests that the prognosis for the Paranoid Type, particularly with regard to occupational functioning and capacity for independent living, may be considerably better than for other types of schizophrenia.