Paranoid schizophrenia is one of the forms of schizophrenia, the main manifestations of which are delusions and hallucinations. At the same time, the structure of the inner and outer world changes completely for the patient.
How the delusional system is formed
This form of schizophrenia arises later in comparison with others. The onset of the disease can go unnoticed, because delirium at first manifests itself exclusively verbally and when talking on more personal topics. Actually, the person's personality remains intact. The word paranoia means "contrary to reason." In paranoid schizophrenia, both delusions and hallucinations are observed.
In order for the patient to develop a stable delusional structure, three phases must go through. In the first phase, the patient is restless, but anticipates the arrival of something that will eliminate the uncertainty. In the second phase, insight comes, everything becomes clear. This sensation is similar to that experienced by the scientist who made the discovery. Illumination changes the perception of all life, as if a person was born again. The patient is delighted, although there are still many uncertainties for him.
Only in the third phase everything fits into a logical scheme, nothing contradicts anything. This stage is also called delusional crystallization. The attachment of certain events to this structure is undeniable, the patient cannot be persuaded. The consistency of his evidence can be shocking. Also, the patient is distinguished by a phenomenal memory regarding cases from the past that belong to a real delusional system. They remember with what facial expression such and such said 10 years ago.
Features of perception and content of delusional ideas
With paranoid schizophrenia, perception is heightened, it is aimed at collecting the smallest details. All random gestures and words of the people around are important, they also relate to the patient's situation. They are used to strengthen the delusional structure. The themes of the new world can be very different. Delirium of grandeur is often encountered - a feeling of false omnipotence and endowing oneself with unrealistic abilities. And there is delirium of persecution, when the patient, on the contrary, feels like a puppet in someone's hands.
At the beginning of the disease, delirium does not reach these extremes, combining delusions of grandeur and persecution at the same time. The patient is great, but he is persecuted and threatened with death. Feelings of superiority usually give vitality and vigor, while the awareness of a threat to one's own existence is overwhelming and disheartening. At a later time, one of the types of delirium begins to prevail.
Hallucinations in paranoid schizophrenia can be visual, auditory, olfactory, or from within the body. In general, the prognosis for this form of the disease is considered the more favorable, the more intense the onset and the richer the psychopathic world of the patient. The patient can give the impression of a normal person for a long time, his delirium is not always aggressively directed against the world around him.