The primary symptoms of paranoid schizophrenia are auditory hallucinations (hearing voices that others do not) and delusions (false beliefs that a person holds despite evidence to the contrary) of being persecuted or plotted against. Patients may also have grandiose (over-the-top) delusions, which may include themes of jealousy or religion.

Patients may have more than one delusion, but there is usually a common theme among delusions. Patients may also experience hallucinations, but the hallucinations usually have the same theme as the delusions.

Other symptoms of paranoid schizophrenia include anxiety, anger, aloofness, disorganized thinking and behavior, and a decline in functioning. People with the condition also tend to be more argumentative, difficult and patronizing. Interpersonal interactions may have a formal or intense quality. Research also indicates that people with schizophrenia may have difficulty interpreting others’ body language.

Because they have delusions of being persecuted or plotted against, patients with paranoid schizophrenia may be more prone to suicide. They may also be more likely to engage in violent behavior because patients sometimes experience anger in addition to delusions. If a patient with paranoid schizophrenia commits an act of violence, it is usually directed at a family member and typically takes place at home.

Patients with paranoid schizophrenia usually do not have symptoms that are present in other types of schizophrenia, such as disorganized speech, “flat affect” (reduced expression of emotion) and disorganized behavior.

Patients with paranoid schizophrenia may exhibit negative symptoms (symptoms that involve a loss of normal emotional and behavioral functioning), but they are less prominent than other symptoms.

Because of the nature of the condition, individuals with paranoid schizophrenia are not likely to seek treatment. Therefore, loved ones of individuals experiencing signs and symptoms of the disorder must often intervene and report signs and symptoms to a physician on the patent’s behalf.