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Implications for Diagnosis and Treatment

Robert Freedman, MD; Paul J. Schwab, MD

Arch Gen Psychiatry. 1978;35(3):387-390.

Abstract
• Paranoid symptoms were found in 40% of patients admitted to a university general hospital psychiatric unit during a tenmonth period. Fifty-eight percent of this group had frank paranoid delusions, while the rest had ideas of reference or generalized suspiciousness. Only one half of those who had paranoid delusions had paranoid schizophrenia. A significant number had affective disorders or organic brain disorder. Ideas of reference and suspiciousness were found in many patients who were not psychotic. The therapeutic implications of these findings are reported in three patients who were inadequately treated for affective disorders because the presence of paranoid symptomatology had led to an incorrect diagnosis of schizophrenia.

Author Affiliations
From the Department of Psychiatry, University of Chicago.

Footnotes
Accepted for publication April 12, 1977.

Reprint requests to Department of Psychiatry, University of Chicago, 950 E 59th St, Chicago, IL 60637 (Dr Freedman).

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ABSTRACT