Delusion of persecution is the distinguishing characteristic in paranoia. "They are talking about me" and "I am being plotted against" are typical and often-stated views. However, paranoids have sufficient judgment and self·control to both avoid hospitalization and function socially. Here they differ from the paranoid schizophrenic. But in extreme cases the person may be a homicidal risk and must be hospitalized. Paranoid individuals may be very intelligent and well educated, but they are completely convinced of their delusional system and cannot be shaken from it. Aside from the delusional system, the paranoiac's behavior may be normal, logical, and coherent.
Paranoiacs are uncooperative and often do not respond well to psychotherapy. They are suspicious of doctors as well as people in general. Some individuals with noticeable paranoid tendencies do maintain good contact with reality except for their suspicions. Some try to isolate themselves from the world, yet are still able to carry on business functions. Some paranoid states are transient and of short duration; others last a lifetime.
