A personality type characterised by an unwarranted lack of trust and a mistaken belief that people around you are acting or saying things with malicious intent.
It is more common in men and has been described as having a genetic component. Physical or emotional abuse during the person's childhood promotes its appearance.
It is often associated with other conditions such as anxiety, post-traumatic stress disorder, alcohol abuse and/or schizophrenia.
Its symptoms are unfounded suspicion of other people, believing that they are trying to lie, deceive or harm them. They are hypervigilant and try to find hidden meanings in possible contempt, insults or threats from people around them. They feel constantly threatened for no reason and have difficulty forming relationships with others because they do not believe in them or fear that the information they share will be used against them.
Diagnosis is made clinically through a guided interview by a mental health professional. The approach can be complex due to the patient's low awareness of the condition and lack of trust in the professional.
Treatment is mainly based on psychotherapy and may include psychotropic medication to treat specific symptoms.
- Torgersen S. Prevalence, sociodemographics, and functional impairment. In: American Psychiatric Association Publishing Textbook of Personality Disorders, 3rd Ed, Skodol AE, Oldham JM (Eds), American Psychiatric Association Publishing, 2021. p.143.
- Torgersen S. Epidemiology. In: The Oxford Handbook of Personality Disorders, Widiger TA (Ed), Oxford University Press, New York 2012. p.186.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, 2013.
- Zimmerman M, Rothschild L, Chelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry 2005; 162:1911.
