Paranoia - SpeedyLook encyclopedia

General presentation

Historically, the term of paranoia was used in Germany throughout the 19th century to qualify any type of Délire. In 1879, Richard von Kraft-Ebing isolates the hallucinatory forms ( paranoia hallucinatoria ) from the others are delirious ( paranoia combinatoria ). It is Emil Kraepelin which more precisely defines paranoia at the end of the 19th century like

the “development slow and insidious of a delirious system durable and impossible to shake, and by the absolute conservation of clearness and about the thought, of wanting, and the action”.

Consequently, paranoia is defined as one is delirious chronic, organized, structured, logical in its development, generally comprising a feeling of persecution, involving a strong adhesion of the patient, but not blocking the other psychic functions. This type of is delirious, says Délire paranoiac preferentially appears at subjects marked by a Personality disorder paranoiac preexistent.

In French, the adjective which corresponds to paranoia is paranoiac and it should not be confused with the paranoid term, of direction very different (Délire paranoid) and used to describe certain types of Schizophrénie.

Paranoiac personalities or characters

The diagnosis of personality disorder supposes, at the affected people, a whole of fixed and rigid generally appearing at the time of the Adolescence and remarkably stable features of personality in time. They involve either a suffering, or of the dysfunctions.

It is of use to distinguish two types of paranoiac personalities: personality (or character) paranoiac itself, and sensitive personality. They are likely various complications.

It should however be noted that in certain situations (depressive syndrome, anxious Trouble, Stress) one can observe features which could make evoke a sensitive personality, but which is related to the psychological state, and thus contextual, transitory and reversible. One cannot thus speak in this case about personality disorder.

Personality (or character) paranoiac

This disorder assigns to 0,3 to 2,5% general population. From a semiological point of view the paranoiac personalities are characterized by four fundamental features which involve a social inadaptability in the long term:

the pathological over-estimate of oneself;
extreme mistrust with regard to the others;
disproportionate susceptibility;
the falseness of the judgment.

DSM-IV defines the paranoiac personality disorder thus:

State of suspicious mistrust invading towards the others whose intentions are interpreted in a malevolent way. The paranoiac personality implies the presence from at least four of the seven symptoms according to:

the subject expects, without sufficient reasons, so that the others exploit it, harm to him or mislead it.
It is worried by unjustified concerning the honesty or the fidelity of his/her friends/associated doubts.
It is reticent to entrust to others because it fears that information is not used against him.
It distinguishes hidden significances, humiliating or menaçantes in the events pain-killers.
It does not forgive to be wounded, insulted or scorned.
It perceives attacks against its person or her reputation, to which it will react by anger or the counter-attack.
It questions in a repeated way and without justification fidelity of joint sound.

Sensitive personality

It is a paranoiac type of personality marked by a high direction of the values morals, pride (a high regard of oneself, which results in being regarded as never sufficiently recognized with its right value), a relational hyperesthesy involving a great vulnerability in the social contacts, and a tendency to self-criticism, the painful interiorization of the failures and susceptibility. One does not find the hypertrophy of ego nor the Quérulence present at the other paranoiac personalities.

Description of the paranoiac psychosis or paranoia

There exist several types of paranoias which however have a certain number of common natures.

Common characters

Paranoia is a chronic mental affection of the group of the Psychose S. It occurs in general between 30 and 40 years, at individuals who generally presented a paranoiac Personnalité preliminary, and it is centered on a Délire. Is delirious is a disorder of the contents of the thought characterized by the permanence of delirious ideas (i.e. ideas obviously in dissension with the usually shared reality and beliefs) of which the subject is convinced During paranoia, this is known as Délire is delirious paranoiac, and it is completely different from the paranoid Délire observed as for him in the Schizophrénie. It is a difference in nature and not degree which exists between the two terms as shows it the following table:

Is delirious paranoiac thus presents several characteristics:

it almost only uses to be built a mechanism of interpretation. In other words, the subject perceives well what arrives to him, but it allots to its experiment a direction different from reality. (Example: “Fire passed to the red when I arrived by car, that shows well that me am supervised. ”)
the topics (i.e. contents) of is delirious is varied, but often relates to ideas of persecution, damage, jealousy, plot, etc
is delirious It known as highly is systematized i.e. it presents an internal high degree of coherence. Insofar as it develops in a perfectly coherent and logical way, even if that is on false premises, it can involve the complete adhesion of the listener.
Lastly, is delirious it paranoiac is known as:

is in sector when there remains limited to a field of the life of the patient (example: a man is delirious on the fact that it is misled by his wife, but does not present any delirious idea in the other sectors of its life);
is in network, when is delirious it relates to little by little all the psychic operation of the subject and all the sectors of its life (as in the theory of the generalized plot).

Is delirious can be out of silencing device several years, before the disorders do not burst. When the disease is declared, it becomes chronic, evolving/moving by pushes. There exist three principal types of are delirious paranoiac: be delirious passion, Délire of interpretation and Délire of relation of sensitive the.

Be delirious passion

They are known as passion because of nature of the feeling which inspire them: passion. These be delirious begin with the first delirious interpretation from reality (For example: " If my wife returned précipitemment in her room it is that it hiding place a connection ") or sometimes by an initial delirious intuition (For example: " Brutally, I very included/understood for my wife, all clearly became "). They develop then with a strong emotional load which can cause a dangerous behavior. On the other hand, is delirious it does not extend to other fields, it remains limited to a main object (is delirious in sector).

Erotomania

Be delirious of jealousy

It touches especially the men, settles in an insidious way, often in a context of alcoholism. Is delirious nourishes gradually event pain-killers, banals, but of which each one comes to feed and reinforce it is delirious.

Be delirious of claim

It is are delirious them systematized and in sector, primarily based on delirious interpretation. They rests on the delirious belief in an undergone damage, accompanied by exaltation, Quérulence and aggressiveness. It is a question for these patients “of making emerge the truth” or of punishing the culprits. One distinguishes:

the impassioned idealist: impassioned by a cause (political, mystical, social), it is made a “mission” of carrying it, and of transmitting it in a fanatic way, and of being the untiring proselyte about it;
the ignored inventor: seeking to make recognize its supposed invention or the anteriority of that Ci compared to its “official” discovery;
quérulent it litigious: delirious conviction to be injured, multiplication of the appeals to justice and the procedures against its supposed persecutors;
is delirious it of filiation: delirious conviction of a famous ascent (often royal, aristocratic or of another character in sight).

Is delirious of interpretation of Serious and Capgras

See also: Is delirious of interpretation of Serious and Capgras

The topics of is delirious, i.e. the contents of interpretations relate to ideas of persecution, damage, plot. The evolution makes that little by little, the whole of the events met by the subject will be attached to the delirious system. For example if a close relation, or a colleague, or a doctor tries to reassure the subject by saying to him that it " is made idées" , that will be immediately interpreted like a sign of membership of the " complot". It is what is called one is delirious " in réseau" since it extends little by little to all the psychic life, and relates to all the fields (emotional, relational and psychic) of the life of the subject. The evolution is chronic.

Is delirious of relation of sensitive of Kretschmer

See also: Is delirious of relation of sensitive the

Is delirious of relation of sensitive settles in the adult, at subjects which had before a personality marked by sensitivity. A delirious state appears progessivement, generally following failures or of disappointments. The topics of is delirious, i.e. the contents of interpretations relate to ideas of persecution, damage, hostility and contempt whose subject would be victim, or of attack of its values morals. Is delirious is in general limited to the circle close to the patient (its family, its friends, its colleagues, its neighbors, etc). He is lived painfully and in a solitary way. He generally becomes complicated depressive episodes sometimes severe. Contrary to what occurs in the other types of paranoia, there is no reaction of aggressiveness towards the entourage, little noisy reaction, nor of dangerosity turned towards others. The suicidal risk exists during the depressive episodes. The evolution is less often chronic than in other paranoias.

Complications

Paranoiac personality

The risk is mainly the evolution towards a paranoiac psychosis made up. It is not systematic, and the patient can show a perfect social adaptation up to that point (Normopathie).

Paranoiac psychosis

depressive Syndrome with suicidal risk (it is in sensitive paranoia that is most frequent)
Passage to the hétéro-aggressive act underlain by delirious motivations. That can go until the murder of the designated persecutor.

Dangerosity

The psychiatric dangerosity of the patients affected by paranoiac psychoses is not to neglect. It is all the more to fear:

that there exists a designated persecutor, i.e. a precise individual, judged as being responsible for persecutions that the subject thinks of enduring
that is delirious it evolves/moves of long time and grew rich during the time
which there exists a Trouble of mood concomittant
which there exists a Alcoolisme and/or an excessive consumption of cannabis

Differential diagnosis

Paranoia should not be confused with:

the Schizophrenia (but one observes in the latter an autistic fold, a dissociative Syndrome, and is there of paranoid type is delirious it);
the chronic hallucinatory Psychosis (the mechanism of is delirious is there almost only hallucinatory);
the Paraphrenia (is delirious it is with topic fantastic, imaginative, without persecution);
the acute delirious Puffed out (they are younger adults, the disorders appear brutally and are transitory of the order a few week in a few months);
a mental Confusion
a irrational Syndrome beginning (association with a mental deterioration beginner).
a Disorder of mood, indeed certain cases of depressions comprise one is delirious persécutif. In this case, the signs of paranoia appear in a contemporary way to the disorder of mood.
Of the paranoiac elements is frequently observed during alcoholic encephalopathies like the syndrome of Korsakoff
Enfin, some cerebral tumors, in particular in the area of the frontal Lobe of the Cerveau, can give tables evoking paranoia.

Certain products can give transitory paranoiac reactions

One speaks then commonly about " Bad trip " or of " trip parano". The following products are most often accused:

Cannabis and all derivatives of THC
Cocaine and Ace
Hallucinogen S

Treatment

Taking into account the Refusal of the disorders which accompanies this affection, good number of people who are reached by it remain without follow-up. Is delirious paranoiac installed is taken in the character and the construction even of the personality. Often any proposal for a care is interpreted like an aggression. Because of the particular relational methods of the paranoiac patients, and risk that looking after it is integrated into is delirious and indicated like persecutor, the assumption of responsibility is seldom possible in cabinet, often it is institutional, calling upon a multi-field team of looking after.

The relation with the paranoiac patient

The therapeutic relation with the paranoiac patient is difficult. The risk is that the therapeutist is initially idealized, before this love does not transform of hatred and into persécutif feeling. In these circumstances, it is not rare that such patients develop a delirious relation with their doctor or their therapeutist. It is thus important to always keep a cordial but sufficiently distant position, and to work in team around the patient.

Medicamentous treatment

the basic medicamentous treatment of the paranoiac psychosis calls mainly upon the incisive Neuroleptique S known as , i.e. having properties antidélirantes (Halopéridol, Risperidone, Olanzapine…) who allow to reduce is delirious it without always managing to remove it completely.
During depressive phases and in the Is delirious of relation of sensitive the, a treatment Antidépresseur perhaps indicated.
During anxious exacerbations, of the periods of agitation or risk of Passage to the act, a more sedative Neuroleptique can be prescribed (Cyamémazine, Chlorpromazine, Lévopromazine…) in a transitory way.

Psychotherapy

The place of the Psychothérapie S in the treatment is restricted for these patients who generally do not regard themselves as patients and who have low capacities of Introspection and of handing-over in question. They can however be proposed in certain cases.

Hospitalization

Ideally, the care is organized into ambulatory, but in certain cases, a hospitalization is necessary:

At the time of depressive phases making run a risk of passage to the suicidal act, sometimes accompanied by homicide (wide suicide).
During phases of delirious exacerbation, sutout if there exists a persecuting indicated , i.e. a person which the patient makes responsible for the troubles that it crosses (a person at the origin of the plot against him, of persecutions which he endures, etc) In these cases, a risk of aggression even of homicide exists making hospitalization a top priority.

In France, the hospitalization must then be done on the mode of the hospitalization under constraint, and more precisely of the hospitalization of office (HO), administrative measure decided by the Prefect and allowing the hospitalization of the patients representing a danger to the law and order and the safety of the people, when this danger is related to a mental disorder. The hospitalization allows the catch of load by a multi-field medical team, which generally authorizes an appeasing and a stabilization of the disorders if a therapeutic relation manages to be outlined.

Theories on the origin of paranoia

There is no biological univocal cause nor genetic recognized with paranoia. For the Psychoanalysis, paranoia finds its source on a wound early Narcissique (at the time of the first interactions between a subject, more or less fragile and its medium more or less able to make it still more vulnerable). The first identifications are failing and the personality disorder often progresses in a latent way until adolescence. Freud and Lacan was interested in the psychoanalysis of paranoia, in particular through the study of the autobiography of a magistrate, the President Schreber. They described mechanisms of defense prévalents during paranoia: the Splitting of the ego, the projection and the Refusal.

Problems arising from the use of this diagnosis

Certaines research of the field of the Sociologie highlighted that the attribution of the diagnosis of paranoia could constitute a means of délégitimer the word of minority groups.
According to certain authors paranoiac operation could be applied in a collective way to groups, in particular with certain groups with totalitarian operation.
a diagnosis of paranoia posed in a totalitarian context is highly suspect. It was sometimes used to muzzle the political opponents by making them intern, as in the USSR: Alexandre Soljenitsyne was thus regarded as paranoiac by the authorities of his country.
paranoia maintenance of the close links with the Theory of the plot. It is sometimes very difficult to make the share of the things, are delirious them paranoiac often seeming strongly logical and coherent, they are likely to convince the listeners. In a certain number of cases, the individuals affirming to know a theory of the plot and having the duty to prevent the world of it, are paranoiac subjects.

Paranoia in art

History of art

Paranoia played a big role in the recontre of the theories freudiennes with the surrealist movement. El Salvador Dalí for example proposed the paranoiac-critical Méthode like mode of artistic creation.

Cinema

'' El '' is a Film of Cinéma of Luis Buñuel left in 1953 which depicts in a clinical way the blossoming and the aggravation of one is delirious of jealousy.
'' Paranoïak '', a Film of American Cinema carried out in 2007 by DJ Caruso.
'' Paranoïa '', a Short film of Cinema carried out by Forest Frederic.
Alfred Hitchcock, Psychosis , inspired partially by a fact various.
Romance Polański, the Tenant , remarkable film in its fine and detailed description of a paranoiac decompensation at a man.
Romance Polański, Repulsion , evocation on the female side of a similar decompensation.
Romance Polański, Rosemary' S Baby , decompensation puerpérale with paranoiac tonality.
David Lynch, Lost Highway , evokes such a universe with ceaseless passages from the point of view external with the intra-psychic point of view according to the cleaved facets of the hero.
William Friedkin, Bug . Bug is a film on paranoia.
Terry Gilliam, Las Vegas Parano. Setting in scene of a paranoia resulting from psychotropic.

Literature

Philip Kindred Dick, whose essential topics turn around the concept of paranoia.

Notes and references of the article

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