Paranoid redirects here. For the Black Sabbath album Paranoid, see Paranoid (album). For the role playing game, see Paranoia (role-playing game).

In popular culture, the term paranoia is usually used to describe excessive concern about one's own well-being, sometimes suggesting a person holds persecutory beliefs concerning a threat to themselves or their property and is often linked to a belief in conspiracy theories.

In psychiatry, the term paranoia was used by Emil Kraepelin to describe a mental illness in which a delusional belief is the sole, or most prominent feature. This usage is now largely obsolete and the term is more typically used in a general sense to signify any self-referential delusion, or more specifically, to signify a delusion involving the fear of persecution. The exact use of the term has changed over time, and because of this, psychiatric usage may vary.

Use in psychiatry

In his original attempt at classifying different forms of mental illness, Emil Kraepelin used the term pure paranoia to describe a condition where a delusion was present, but without any apparent deterioration in intellectual abilities and without any of the other features of dementia praecox, the condition that was later to be renamed schizophrenia.

In the original Greek, παράνοια (paranoia) means self-referential, and it is this meaning which was adopted by Kraepelin. Notably, in this definition the belief does not have to be persecutory to be classified as paranoid, so any number of delusional beliefs which are centred around the self can be classified as paranoia. For example, a person who has the sole delusional belief that they are an important religious figure (such as Jesus or the Dalai Lama) would be classified by Kraepelin as having 'pure paranoia'.

Although the diagnosis of pure paranoia is no longer used (having been superceded by the diagnosis of delusional disorder) the use of the term to signify the presence of delusions in general, rather than persecutory delusions specifically, lives on in the classification of paranoid schizophrenia, which denotes a form of schizophrenia where delusions are prominent.

More recently, the clinical use of the term has been used to describe delusions where the affected person believes they are being persecuted. Specifically, they have been defined as containing two central elements:

1. The individual thinks that harm is occurring, or is going to occur, to him or her.
2. The individual thinks that the persecutor has the intention to cause harm.

Paranoia is often associated with psychotic illnesses, particularly schizophrenia, although attenuated features may be present in other primarily non-psychotic diagnoses, such as paranoid personality disorder.

Examples of clinical paranoia

In the unrestricted use of the term, common paranoid delusions can include the belief that the person is being followed, poisoned or loved at a distance (often by a media figure or important person, a delusion known as erotomania or de Clerambault syndrome).

Other common paranoid delusions include the belief that the person has an imaginary disease or parasitic infection (delusional parasitosis); that the person is on a special quest or has been chosen by God; that the person has had thoughts inserted or removed from conscious thought; or that the person's actions are being controlled by an external force.

Many despotic rulers (for example Stalin) allegedly suffered from paranoia. This presents an interesting question because in Stalin's case, it is quite likely that many people really were out to get him (some theories state he was finally poisoned). Might it be that with enough enemies, it is impossible not to be clinically paranoid? It still might be possible to identify a paranoid in that situation via his unrealistic assessment of the relative threat presented by various enemies, but it is not clear that non-paranoid persons are all that good at this. This raises interesting philosophical questions about the criteria by which we can diagnose a belief as paranoid or delusional.

Paranoia depicted in popular culture

In popular culture paranoia is often represented as including:

• Belief in having special powers or being on a special mission (a "delusion of grandeur");
• Conspiracy theories, such as seeing seemingly unrelated news events as parts of a larger, typically conspiratorial plan
• Black helicopters and other mass surveillance
• Persecution from powerful adversaries such as UFOs, the Men in Black, secret societies or demons
• Mind control through invisible rays, and tinfoil hats to combat them;
• Fear of poisoning, adulterated food (e.g., aspartame) or water (e.g., fluoridation) as part of a secret plot.
• Reading a story (or watching a movie) and feeling that one's life is exactly like the story.

See also

• Delusion
• Delusional disorder
• James Tilly Matthews
• Monomania
• Paranoid personality disorder
• Schizophrenia
• Paranoia RPG

Further reading

• Freeman, D. & Garety, P.A. (2004) Paranoia: The Psychology of Persecutory Delusions. Hove: Psychology Press. ISBN 184169522X
• Munro, A. (1999) Delusional disorder. Cambridge: Cambridge University Press. ISBN 052158180X
• Sims, A. (2002) Symptoms in the mind: An introduction to descriptive psychopathology (3rd edition). Edinburgh: Elsevier Science Ltd. ISBN 0702026271

• Several programming libraries are called Paranoia
• Paranoia is also a CD-ripping tool.
• "PARANOiA" is the name of a song (and, informally, its remixes) from the Dance Dance Revolution music video game series.