Paraphrenia: Types, Symptoms And Treatment Of This Disorder

This mental alteration goes hand in hand with very fanciful and irrational delusions about reality.

The most serious mental disorders do not have to express themselves only through hallucinations. Sometimes they do it through  delusions, which are totally irrational beliefs resistant to the physical evidence that contradicts them.

This type of phenomenon is precisely what occurs in a mental disorder known as paraphrenia, which is something like a chronic delirium. Next we will see what are the types, symptoms and treatments associated with this health problem.

What is paraphrenia?

The term “paraphrenia” refers to a chronic psychosis, that is, a break with reality that leads one to believe very bizarre and unreasonable ways of understanding things. In addition, what characterizes paraphrenia are not hallucinations but delusions, although the former can also occur in some cases.

As it is a mental health problem, paraphrenia causes suffering to the person who suffers from it and / or the people around them, but being chronic, it does not have an immediate cure.

In addition, the delusions that appear in paraphrenia are very flowery, that is, in them there are many strongly irrational components, a great variety of recurring themes, relatively complex narratives about what reality is like, and these affect many facets of life. life of the person. For example, a delusion that appears in paraphrenia may consist of a conspiracy of humanoid ants to control all sources of water on the planet.

The word “paraphrenia” was proposed by the psychiatrist Karl Kahlbaum during the 19th century, and its meaning was developed by Emil Kraepelin a few decades later. For this reason, it is currently considered an imprecise clinical category with little use in professional practice. As it is not very well defined in comparison to other psychiatric entities, it does not appear in the ICD-10 or DSM-5 diagnostic manuals, but despite this it is still common today.


The symptoms associated with paraphrenia are as follows.

1. Tendency to mistrust

Patients whose behavior resembles the descriptions of praphrenia, on many occasions, tend to distrust others in a very striking way. Many times, this goes so far as to become a delusion of persecution; Ambiguous facts are perceived as signs that someone is following in their footsteps.

In practice, this symptom has led to the concept of praphrenia being related to  paranoid schizophrenia.

2. Erotic delusion

People with paraphrenia often believe they arouse the erotic passions of others, which gives them an excuse to feel persecuted.

3. Delusion of grandeur

The patient believes he is someone important or powerful, which is why he also makes sense of the fact that many entities are interested in him and want to influence his life (or put it in danger, as is usual in this type of delusions) .

4. Solipsism and self-reference

Patients with a condition associated with paraphrenia tend to believe that apparently events are not very related to themselves, in reality, they are, as if many things happened because of their existence or proximity.

5. Intelligence preserved

Unlike what happens in  dementias, people with mental problems linked to paraphrenia do not have a significantly low level of intelligence, and beyond their beliefs and delusions their way of thinking is functional.

6. Hallucinations

Although they do not occur in all cases, they can sometimes appear, especially visual and auditory ones. These appearances reinforce the delusions of the person.

Types of paraphrenias

Paraphrenias can be classified as:

  • Fantastic paraphrenia : linked to strongly fantasy delusions, it ends in dementia after a few years.
  • Expansive paraphrenia: associated with delusions of grandeur.
  • Confabulatory paraphrenia: characterized by a deformation of memories and the invention of stories about the past.,
  • Systematic paraphrenia: it is based on an intensifying delusion of persecution.


As it is a psychiatric disorder, medication with psychotropic drugs is common to treat psychoses such as paraphrenia. Specifically, substances commonly used are certain types of  neuroleptics such as thioridazine. Keep in mind that any drug has side effects.

On the other hand, as it is rare for patients to go to consultation of their own free will, it is necessary to work in the therapist-patient alliance so that treatment is not abandoned, and it is also recommended to combine this pharmacological approach with  cognitive-behavioral psychotherapy and  relaxation techniques. 

The objective of these interventions is not to definitively cure the disorder, in the sense of making the symptoms stop appearing, but to make the flare-ups less frequent and the psychotic symptoms more controllable and generate less anxiety and discomfort.

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