Paranoid Symptoms Among Older Adults

Muzumel A. Chaudhary, MD; Kiran Rabheru, MD, CCFP, FRCP, ABPN


Geriatrics and Aging. 2008;11(3):143-149. 

In This Article


Paranoid symptoms can present as persecutory delusions, paranoid ideation, or even increased suspiciousness and are nonspecific signs that can be present in a number of conditions of late life. Delusions of being stolen from are among the most common examples of paranoid symptom the clinician is likely to encounter.

A delusion is a fixed, false, idea or belief that is out of keeping with the person's educational, cultural, and social background. It is held with extraordinary conviction and subjective certainty, often despite contradictory evidence.[4] Delusions can take many forms, varying in content from persecutory, erotomanic, grandiose, somatic, and jealous themes. Persecutory delusions are the most common; the individual believes that he or she is being stolen from, spied on, followed, poisoned, harassed, prevented from attaining a goal, or unfairly treated.[5]

Paranoid ideation differs from a delusion in the reduced intensity of the person's conviction, the beliefs being less firmly held. The beliefs are neither delusional nor obsessional in nature, but nonetheless remain preoccupying to the extent that they cause disturbed functioning or suffering to the individual or others.[4] The individual reacts with mild suspiciousness and/or paranoia to many of the same themes as listed above, for example, feelings of being unjustly treated, harassed, stolen from, etc. However, the reaction is milder and better tolerated by those experiencing paranoid ideation versus delusion, and they are in better control of their behaviour, able to get through life with minimal disruption to their own or others' psychological or functional well-being.


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