Paranoid Schizophrenia

Paranoid schizophrenia is the most common type of schizophrenia in most parts of the world.
The clinical picture is dominated by relatively stable, often paranoid, delusions, usually
accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances.
Disturbances of affect, volition, and speech, and catatonic symptoms, are not prominent.

Examples of the most common paranoid symptoms are:

 delusions of persecution, reference, exalted birth, special mission, bodily change, or

jealousy;
 hallucinatory voices that threaten the patient or give commands, or auditory
hallucinations without verbal form, such as whistling, humming, or laughing;
 hallucinations of smell or taste, or of sexual or other bodily sensations; visual
hallucinations may occur but are rarely predominant.

Thought disorder may be obvious in acute states, but if so it does not prevent the typical
delusions or hallulcinations from being described clearly. Affect is usually less blunted
than in other varieties of schizophrenia, but a minor degree of incongruity is common, as
are mood disturbances such as irritability, sudden anger, fearfulness, and suspicion.
"Negative" symptoms such as blunting of affect and impaired volition are often present
but do not dominate the clinical picture.

The course of paranoid schizophrenia may be episodic, with partial or complete remissions, or
chronic. In chronic cases, the florid symptoms persist over years and it is difficult to distinguish
discrete episodes. The onset tends to be later than in the hebephrenic and catatonic forms.

Diagnostic Guidelines

The general criteria for a diagnosis of schizophrenia (see introduction to F20 above) must be
satisfied. In addition, hallucinations and/or delusions must be prominent, and disturbances of
affect, volition and speech, and catatonic symptoms must be relatively inconspicuous. The
hallucinations will usually be of the kind described in (b) and (c) above. Delusions can be of
almost any kind of delusions of control, influence, or passivity, and persecutory beliefs of
various kinds are the most characteristic.

Includes:

paraphrenic schizophrenia
Differential diagnosis. It is important to exclude epileptic and drug-induced psychoses, and to
remember that persecutory delusions might carry little diagnostic weight in people from certain
countries or cultures.

Excludes:
involutional paranoid state (F22.8)
paranoia (F22.0)

Source: ICD-10 copyright © 1992 by World Health Organization.

http://www.schizophrenia.com/szparanoid.htm

http://books.google.com/books?id=5RX1SyN7znoC&q=paranoid+schizophrenia#v=snippet&q=paranoid
%20schizophrenia&f=false (paint-paranoid1 reference) (orient,2009)

for nsg dx (Kim A. Jakopac, Sudha C. Patel

Jones & Bartlett Learning, 2008 - Medical - 320 pages
A supplement to a full-length psychiatric mental health nursing textbook that provides full length case
scenarios for clients who need both psychiatric mental health care and medical care.)
http://books.google.com/books?id=_h9uR-
t9R7UC&pg=PA136&dq=NURSING+DIAgnosis+for+paranoid+schizophrenia&hl=en&ei=C9RrTZquDIrkrAe
rweXCCw&sa=X&oi=book_result&ct=book-preview-
link&resnum=10&ved=0CFwQuwUwCQ#v=onepage&q=NURSING%20DIAgnosis%20for%20paranoid
%20schizophrenia&f=false