Paranoid schizophrenia: An unorthodox view.

Abstract

Most paranoid patients have traditionally been diagnosed as schizophrenic, although considerable evidence points to the dissimilarities between paranoid and nonparanoid schizophrenic patients and to commonalities between paranoid and affective disorder groups. Based on a review of research, it is suggested that paranoid schizophrenia, at least in some of its varieties, may more fruitfully be conceptualized as a phenotypic expression of an underlying depressive mode than as a schizophrenic form. This formulation is presented within the framework of a broad examination of diagnostic issues.

Attributional style in paranoid vs. depressed patients

“…According to psychodynamic theory, it is the grandiose delusions which epitomize enhancement of self-esteem (Zigler & Glick, 1984, 1988 and defend against feelings of self-reproach (Cameron, 1975). Although there were no differences between the paranoid only and the paranoid/depressed groups with respect to ideas of influence, ideas of reference, being punished or conspired against, and expressions of hostility, the paranoid only group was significantly more grandiose than the paranoid/depressed group (.y = 3.78, p < .05).…”

“…This refinement was essential given the postulated existence of a paranoid-depressive continuum (Schwartz, 1963). Furthermore, on theoretical grounds, Zigler & Glick (1984, 1988 have argued that paranoia is a defence against depression and may represent an overt manifestation of an underlying depression. There should therefore be an inverse relationship between depressive and paranoid symptomatology during the course of the disorder, and depression should be found more in paranoid schizophrenia than in any of the other subtypes (Zigler & Glick, 1984, 1988.…”

“…Furthermore, on theoretical grounds, Zigler & Glick (1984, 1988 have argued that paranoia is a defence against depression and may represent an overt manifestation of an underlying depression. There should therefore be an inverse relationship between depressive and paranoid symptomatology during the course of the disorder, and depression should be found more in paranoid schizophrenia than in any of the other subtypes (Zigler & Glick, 1984, 1988. Indirect evidence favouring this deduction comes from Westermeyer & Harrow (1989), who noted that paranoid schizophrenics are more likely to commit suicide than other subtypes of schizophrenia.…”

Impoverished Dialogical Relationship Patterns In Paranoid Personality Disorder

“…According to Colby (1981) behind paranoia there is a set of strategies aiming at either forestalling or tackling these feelings of shame and humiliation. The paranoid style of distrust and grandiosity is a cognitive defence against the subjects' feelings of low self-esteem and the perception that they will be rejected and fail (Leahy, 2002;Zigler & Glick, 1984;1988).…”

Long‐term course and outcome in delusional disorder

“…The first (9) is that delusional disorder (DD) (paranoia) is a variant of schizophrenia (S). The second (10,11) is that paranoid disorders are related to affective illness. A third view (12) is that only the deteriorating paranoid psychotic disorders belong to S (dementia praecox).…”