Mental Health Psychotic Disorders Signs and Symptoms of Paranoid Schizophrenia Medically referred to as schizophrenia with paranoia By Sherry Christiansen Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Updated on April 19, 2021 Medically reviewed by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Frequent Symptoms Complications When to See a Doctor Treatment Paranoia is a pattern of thinking in which one feels irrationally suspicious, persecuted, or threatened. It can range from mild feelings of discomfort to an intense, extremely distressing and disabling pattern of thinking. For people with schizophrenia, the experience of paranoia can be persistent, extremely unpleasant, and even dangerous. Up until 2013, schizophrenia was categorized into different subtypes, with paranoid schizophrenia being one of them. It is no longer considered a definitive subtype of the disorder, so the term paranoid schizophrenia is not officially correct. However, paranoia is a common symptom of schizophrenia, so one could be described as having schizophrenia with paranoia. Madrolly / Getty Images What Is Schizophrenia With Paranoia? Frequent Symptoms For those with schizophrenia with paranoia, reality may be unclear. For example, in addition to their paranoia, they may see people and hear voices that they believe are real, but in fact are not. As one could imagine, this can interfere with a person’s ability to live a normal life. Examples of early symptoms that might reflect a prodrome for the onset of schizophrenia with paranoia include: Avoiding social events and interactions Insomnia Irritability Problems at work or school Increase in problems getting motivated Social isolation Problems focusing or paying attention Other signs of schizophrenia with paranoia often include: Seeing things that others do notHearing voices that are not thereOverall fear linked with the intention of others (paranoia about being poisoned is a common fear)SuspiciousnessOngoing, bizarre, or unusual thoughts or beliefsTrouble thinking clearlySocial isolationA decline in overall hygiene or other aspects of self-care Phases of Schizophrenia There are several phases of schizophrenia as the disorder progresses from the early warning signs—referred to as the prodromal phase—to the active phase of the disease, in which distortions in perception and debilitating thoughts are present. Having these symptoms does not necessarily indicate that a person has schizophrenia with paranoia, but the presence of symptoms does warrant an evaluation by a mental health professional. Early intervention often equates to better treatment outcomes for people diagnosed with schizophrenia with paranoia. Delusions Delusions are resolutely held untrue beliefs; these beliefs are maintained despite evidence to the contrary. Examples of common types of delusions that people with schizophrenia may have include: Delusions of grandeur: Believing that one has special talents or gifts, immense wealth, or other important traitsDelusions of control: Thinking one is being controlled by entities such as aliens, the government, voices coming from the television, or other outside forcesDelusions of persecution: Believing that one or more people are conspiring against you or a loved one, trying to harm you, or otherwise mistreat youDelusions of reference: The false belief that an unrelated occurrence has a direct reference to oneself Approximately 90% of people who are diagnosed with schizophrenia have some type of delusions. Although not all delusions are the same, there are some commonalities in some people. For example, believing that another person is poisoning one’s food or drinks is a common delusion of persecution. Hallucinations There are several types of hallucinations, including: Visual hallucinations: Seeing something that is not real or does not existAuditory hallucinations: The perception of non-existing sounds, such as perceived voicesOlfactory or gustatory hallucinations: Smelling scents or odors and tasting tastes that do not exist; most often the scents are unpleasantTactile hallucination: Having a sensation that one is being touched—such as something crawling on the skin—when it is not occurring Voices can be: Male or femaleA person who is known or an unknown personSounds instead of human voices, such as a humming soundSpoken by a person with a foreign accentSpoken in a whispering voice or via shoutingNegative and disturbingOngoing or intermittentMore than one voiceCommenting or criticizingGiving commands Disorganized Speech People with schizophrenia may have a symptom called “disorganized speech.” This doesn’t mean that a speech impediment is present; rather, it involves speech that gets derailed or is incoherent. It may involve the repetition of words and phrases, or starting to talk in the middle of a sentence instead of at the beginning. This symptom stems from disorganized thinking that people with schizophrenia often have. Sometimes this type of speech is referred to as word salad. Disorganized Behavior Disorganized behavior is the overall inability to control outward behavior, including emotions and impulses. Examples of how disorganized behavior may manifest in a person with schizophrenia with paranoia include: Difficulty performing daily activitiesAbnormal movements or lack of movementsTrouble with impulse controlProblems controlling emotionsDifficulty containing actions that are deemed inappropriate or odd Disorganized behavior can have a major negative impact on a person’s job, education, and home life, interfering with personal relationships. Suicidal Thoughts Suicidal thoughts and attempts are at an increased risk in people with schizophrenia with paranoia. Suicidal thoughts occur more frequently in people who have untreated schizophrenia with paranoia. Seek Help If you or someone you know has any thoughts of self-harm, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911. Complications Many co-occurring conditions commonly affect a person with schizophrenia with paranoia. For instance, people with schizophrenia often use alcohol or illicit drugs to try and manage their symptoms. Another complication is the development of co-occurring mood and anxiety disorders. Additional complications of schizophrenia may include: Nicotine addictionFinancial problemsLoss of a jobHomelessnessSuicide When to See a Doctor If a person with schizophrenia is thinking about suicide and particularly if they admit to having formulated a plan to commit suicide, it’s of the utmost importance to seek emergency medical intervention right away. There are many suicide crisis lines—available via a phone call—that are standing by 24/7. Among these are: 911 (for emergency medical care, or visit the nearest hospital emergency room)National Suicide Prevention Lifeline at 988, or text the Crisis Text Line (text HELLO to 741741) Treatment A person with schizophrenia usually seeks treatment during the active phase of the disorder. This is when the positive symptoms of psychosis (such as hallucinations) emerge, creating a major disruption in a person’s life. Below is a sampling of the effective treatments available to manage these symptoms. Medications for Schizophrenia Antipsychotic Medications Antipsychotic medications are perhaps the most common type of treatment for people with schizophrenia with paranoia. These medications work to reduce or eliminate psychosis such as hallucinations and delusions. Antipsychotic medications may be given: By mouth each dayIn a pill or liquid formEvery several weeks as an injectable form (which is the preferred route of administration for those who are non-adherent with taking their medications) Difficulty Administering Medication People with schizophrenia with paranoia often have delusional thinking that involves the belief that they are being poisoned. This might translate to non-compliance with taking medications. Psychosocial Treatments Many types of psychosocial treatments are deemed effective in helping people with schizophrenia pursue their life goals. Psychosocial treatment modalities include: Cognitive behavior therapyBehavioral skills trainingSupported employmentCognitive remediationFamily education and supportCoordinated Specialty Care (CSC) 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychiatric Association. What is schizophrenia? Cagliostro, D. Psycom. Paranoid schizophrenia. Help Guide. Schizophrenia symptoms and coping tips. Chaudhury S. Hallucinations: clinical aspects and management. Industrial Psychiatry Journal. 2010;19(1):5. doi:10.4103/0972-6748.77625 Rethink Mental Illness. Schizophrenia. Hor K, Taylor M. Review: Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010;24(4_suppl):81-90. doi:10.1177/1359786810385490 National Institute of Mental Health. Schizophrenia. Miklowitz DJ, Goodwin GM, Bauer MS, Geddes JR. Common and specific elements of psychosocial treatments for bipolar disorder: a survey of clinicians participating in randomized trials. Journal of Psychiatric Practice. 2008;14(2):77-85. doi:10.1097/01.pra.0000314314.94791.c9 By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit