This is the 2007 version. Click here for the 2017 chapter 12 table of contents.

Paranoid Schizophrenia

Paranoid schizophrenia is the most common type of schizophrenia. It is characterized by prominent delusions that usually involve some form of threat or conspiracy, such as secret plots to control people's brains through radio transmissions. A paranoid schizophrenic may believe an alien force is controlling his or her thoughts. Also common in paranoid schizophrenia are delusions of grandeur, a feeling of possessing absolute truth or the solution to the world's problems. The paranoid schizophrenic does not necessarily show the flat or inappropriate affect of a disorganized schizophrenic and may, in fact, seem like an intelligent person who wants to hold an intense, earnest conversation about subjects that happen to be very weird and unbelievable.

What are characteristics of paranoid schizophrenia?

In July, 1998, a man named Russell Westen, who had been diagnosed as a paranoid schizophrenic, entered the Capitol Building in Washington, D.C., with a handgun, killing two security guards before he was shot and injured himself. As it turned out, the man had refused to take his medications. He was delusional, claiming that the President was conspiring to kill him. Once he claimed that the satellite dish in his little town in Montana was spying on him for the CIA. His parents said that he believed secret powers were trying to control him through the TV set. The man's symptoms read like a textbook description of paranoid schizophrenia. Not all paranoid schizophrenics are dangerous; most of them are not. However, when they begin to act on their fantasies, like this man did, they can become dangerous.

Why was the man not in a mental hospital? He had several run-ins with the law, but he never did anything serious enough to be arrested, so he remained free. In the aftermath of the shootings in the Capitol, there were many recriminations against the United States health care system.

Such blaming is easy and perhaps justified, but it ignores the more difficult issues. The man had stopped taking his medications, as many schizophrenics do when released from the hospitals. When he was on his medications, the symptoms cleared up. However, it is difficult to force a person to take medications! It was not until 2002 that the courts in the United States decided it was legal to compel Russell Watson to take his medications; until then, he avoided trial by refusing medications, which left him in a psychotic state.

How is paranoid schizophrenia distinguished from the paranoid personality disorder?

There is a difference between paranoid schizophrenia and the paranoid personality disorder. The paranoid personality disorder is not a form of schizophrenia. The person with only a personality disorder does not have delusions or hallucinations, just extreme suspiciousness. A paranoid schizophrenic has a complex delusional system that is usually organized around some coherent theme involving persecution or conspiracies by powerful, secret forces. If the paranoid schizophrenic hears voices, they usually relate to this theme.

A student brought in a post card his father's company received in their headquarters office. It was addressed to "President-Staff and Chaplain" and read as follows:


Do you allow spying by Mafia and Russians on defenseless children for incest, prostitution, robbery, rape, sacrifice, satanic gang power? Can humans be placed on meat grinders? Can Mafia drug pushers control children drug pushers? What are false claims for child support? Do crooked politicians appoint crooked judges, preachers, and doctors? Can Mafia prostitutes control our towns from N. Y., Chicago, etc? Why are spy prostitute gangs for military contracting to robbery children (civilian) by military Mafia "spy" police state? Are children surgical spy targets for Mafia and crooked police?

The wild associations, the suggestion of a far-reaching conspiracy, the compulsion to share this truth with the world-all are characteristic of the thought processes of a paranoid schizophrenic.

Ironically, considering the bizarreness of their symptoms, paranoid schizophrenics often show little impairment in other respects. They can be intelligent people. Often they can function well on a job. Their prognosis or outlook for the future is better than that of other schizophrenics. In other words, they are more likely to get better and resume a capacity for independent living.

Write to Dr. Dewey at

Don't see what you need? Psych Web has over 1,000 pages, so it may be elsewhere on the site. Do a site-specific Google search using the box below.

Custom Search

Copyright © 2007-2011 Russ Dewey