Paranoid Schizophrenia: Characteristics, Diagnosis and Symptoms

Paranoid schizophrenia is a dangerous immutable neurodevelopmental disorder that affects a person’s thinking, feels, and behaves. Paranoid schizophrenia is, according to DSM-IV (1), “characterized due to the presence of misinterpretation and illusion. pronounced in a context of relative preservation of coherent functions and reaction.”

The types of schizophrenia are defined by the symptoms that predominate in the evaluation of the patient with schizophrenia, and the picture often includes symptoms that are characteristic of more than one subtype.

Due to this lack of specificity, these subtypes have recently been deleted in the latest update of the American classification of mental illness. However, we now describe the characteristics that most defined these subtypes:

  • Paranoid Schizophrenia
  • Disorganized schizophrenia
  • Catatonic schizophrenia
  • Residual schizophrenia
  • Undifferentiated schizophrenia
  • Simple schizophrenia


Characteristics of Paranoid Schizophrenia

The main characteristic of the paranoid type of schizophrenia consists of the presence of clear delusions and auditory hallucinations without clear alterations in affectivity, language and without showing associated catatonic behavior. 

Fundamentally, delusions are of persecution, damage, or both, but delusions can also be presented with another theme, although they are usually organized around a coherent theme. It is also common for hallucinations to be related to the content of the delusional theme. Associated symptoms include anxiety, anger, withdrawal, and a tendency to argue. Onset tends to be later than in other types of schizophrenia, and the distinctive features may be more stable over time.



There is no test for diagnosing schizophrenia. Rather, the disease is recognized by its symptoms (established by a psychiatrist). This specialist questions the patient about his ability to work, to have social relations, or to function in everyday life. They may also ask family members and friends about the person’s behavior.

The doctor (usually a psychiatrist) makes the diagnosis of schizophrenia if the symptoms meet the criteria (based on the existence of certain symptoms over some time) of diagnosis. Besides, other possible causes of symptoms must be eliminated. Psychotic behaviors may occur in the presence of mood disorders, certain neurological diseases (e.g., brain tumors), certain metabolic or autoimmune diseases, Huntington’s disease, liver disease, or reactions to certain medications. Addiction can also lead to certain behaviors that evoke the symptoms of schizophrenia.

For further exploration, the doctor may request a CT scan or magnetic resonance imaging (MRI). These tests, which provide detailed images of the brain, can be used to rule out diseases other than schizophrenia. Although CT and MRI are not diagnostic, they do show some of the changes that occur in people with schizophrenia.



Positive symptoms:

  • Changes in perceptions: auditory and visual hallucinations;
  • Changes in thinking and beliefs: delirium, incoherent remarks
  • Behavior changes: disorganization, weirdness.


Negative Symptoms:

  • Difficulty communicating (analogy);
  • Difficulty feeling pleasure (anhedonia);
  • Lack of energy and motivation (aboulia);
  • The poverty of thought;
  • Social withdrawal (isolation);
  • The decrease in the expression of emotions (blunt affect).


Cognitive symptoms

The person with schizophrenia also has great difficulty making decisions, which leads them to change their minds, hesitate for a long time before making mundane decisions, say no when they think yes (or vice versa), and then regret what they have just said.