Paranoid Type of Schizophrenia: Symptoms & Treatment

Instructor: Yolanda Williams

Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.

Paranoid-type schizophrenia is the most common subtype of schizophrenia in the United States. Learn about paranoid-type schizophrenia, how it is treated, its symptoms, and more.


Imagine that you are a clinical psychologist in a therapy session with one of your male clients. He tells you that he has been hearing voices in his head that have been threatening to take his life. He believes that the government has placed an implant in his brain and is plotting to kill the client and his family, even though several people have tried to convince him otherwise. The client is extremely anxious, guarded, and untrustworthy of strangers. He even admits to carrying a knife on him at all times and sleeping with a gun underneath his pillow for protection. Your client has just exhibited several symptoms of paranoid-type schizophrenia.

Schizophrenia Defined

So what do we mean by schizophrenia? Schizophrenia is a mental disorder that usually appears between late adolescence and early adulthood, although it is possible to show signs of schizophrenia at any time. The symptoms of schizophrenia vary from person to person, but all schizophrenics have at least one of the following symptoms:

  • Delusions: False beliefs, i.e. the belief that people are trying to kill you, the belief that you have special powers, or the belief that the government can read your mind
  • Hallucinations: hearing (most common), seeing, smelling, tasting, or feeling things that are not present
  • Bizarre behavior: Behaving in ways that are not appropriate to society, i.e. wearing your underwear outside of your clothes, walking backwards everywhere, and walking around naked in public places
  • Disorganized speech: You talk in ways that are incomprehensible or hard to understand, i.e. speaking in incomplete sentences, changing topics at random with no connection between the ideas
  • Negative symptoms: Loss of motivation, loss of interest in activities that you once found pleasant, not attending to personal hygiene, social isolation, and little to no emotional expression

Paranoid-Type Schizophrenia

Hearing voices, delusions, becoming socially isolated, and feeling suspicious and guarded are symptoms of paranoid-type schizophrenia. People with paranoid-type schizophrenia have feelings of persecution. That is, they believe that someone is out to get them or their loved ones. People with paranoid-type schizophrenia have delusions that are associated with protecting themselves or their loved ones from persecution. They can also be very anxious, guarded, suspicious, and angry.

The key features of paranoid-type schizophrenia are hearing voices and the delusions. Disorganized speech is not usually seen with this type of schizophrenia. Although the behaviors of a person with paranoid-type schizophrenia may be someone atypical (i.e., sleeping with a gun under your pillow), they are different from the bizarre behaviors that one would normally see in other types of schizophrenia, (i.e. walking outside in the nude or laughing at a funeral). People with paranoid schizophrenia usually have normal intellectual functioning and are able to express affect.

Other symptoms of paranoid-type schizophrenia include:

  • Violent behaviors
  • Thoughts of suicide and suicidal behaviors
  • Being argumentative

Treatment of Paranoid-Type Schizophrenia

Because there is no cure for schizophrenia, the treatment is a life-long process. The treatment for all types of schizophrenia is very similar. Treatment varies based on the symptoms that are present, the severity of the symptoms, the client's medical history, the client's age, and other factors that are relevant to the client.

The treatment of paranoid-type schizophrenia usually involves a team approach. The team members work together to plan, implement, and monitor treatment needs. A treatment team may consist of a psychiatrist, primary care doctor, psychologist, pharmacists, caseworker, a psychiatric nurse, and close family members.

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