Paranoid personality disorder: new areas of research in diagnosis and treatment

Il disturbo paranoide di personalità: nuove linee di ricerca nella diagnosi e per l’impostazione dei trattamenti

T. Agnello, C. Fante, C. Pruneti

Dipartimento di Medicina Clinica e Sperimentale, Università di Parma


The aim of this paper is to consider the new guidelines to better investigate and assess the cognitive and relational factors and the level of quality of life in patient with Paranoid Personality Disorder (PPD). We take into account influencing factors as the epidemiological ones, the co-morbidity, cognition, self-esteem level, metacognitive impairment, number and quality of interpersonal relationships and the difference between “Bad Me” and “Poor me” Paranoia. All of these, in a different miscellanea between individuals ,could be assessed and managed to make a correct clinical diagnosis and for the administration of the best integrate treatment.


The literature of the last 6 years referring to the scientific studies of Pub Med’s data base was analyzed.


Traumatic events in the life, in special during childhood, like physical, emotional and sexual abuse, seems to increase the risk to develop a Personality Disorder (such the Paranoid ones). There is a dynamic relationship between experiential avoidance, self-esteem, and paranoia: low self-esteem leads to higher experiential avoidance and higher paranoia. Furthermore, PPD implies poor quality of life and impairment in the general functioning and increase the risk of cardiovascular disease like stroke or ischaemic heart disease.
The assessment appears to be not too easy because of the high co-morbidity with other psychiatric disorders, but so important to address the patient to appropriate integrate treatment.


Physical/sexual emotional abuse/neglect are associated with personality disorder included Paranoid Personality Disorder. Patients with Paranoid Personality Disorder seem to be characterized by a so lower self-esteem and report higher levels of experiential avoidance than non paranoid subjects. The experiential avoidance and the problems in managing stress situations could decrease self-esteem and quality of life.

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