By:- firoz qureshi

Dept. psychiatric nursing

DEFINITION

The word paranoid means

“ Delusional ”. It is characterized by pervasive, unwarranted, long standing suspiciousness and mistrust of others.

EPIDEMIOLOGY

Prevalence is rare and is over represented in leaders of mystical or esoteric religions.

More common in men.

DIFFERENTIAL DIAGNOSIS

The disorders in which paranoid disorder occur are briefly described in the following :

Paranoid Personality Disorder

Paranoid Schizophrenia

Paranoia

Organic Mental Disorder

Paranoid Personality Disorder

It is a personality disorder characterized by :

Persistent Delusions :

Delusion of persecution – Delusion that one is or will be without material possessions.

Delusion of Jelousy – Delusions that ones lover is unfaithful.

Somatic Delusion – Delusion pertaining to the functioning of ones body.

Persistent Hallucination

Auditory Hallucination- Hallucinatory voices.

PARANOID SCHIZOPHRENIA

It is most common type of schizophrenia. Theclinical picture is dominated by relativelystable often paranoid, delusions , usuallyaccompained by hallucinations.

PARANOIA

It is a rare chronic psychosis in whichsystemized delusions developgradually without hallucination.Delusions are mostly from grandeur

ORGANIC MENTAL DISORDER

In senile dementia of the paranoid reaction type, the principle characteristic is a gradual formation of delusion the individual develop a motion that his relatives are going to rob or kill him.

TREATMENT

A) DRUG THERAPY :

Typical Antipsychotic medication

a) Tab. Haloperidol – 5 to 30 mg per day

b) Tab. Chlorpromazine ( CPZ ) – 300 to 1000 mg/day

c) Tab. Pimozide – 4 to 12 mg/day

d) Tab. Trifluoperzaine – 15 to 50 mg/day.

NURSING INTERVENTIONS

A) Misinterpretation of patients are clarified, arguments are avoided.

B) Careful monitoring is needed if the delusions lead patients to harm themselves or others.

C) Discourage long discussion about the irrational thinking, instead talk about real events and real a people.

D) Encourage the patient to express feelings as much as possible.

NURSING INTERVENTIONS

E) Help the patient learn that he can dismiss hallucinations by saying “ go away” or “ be quite”

F) Provide a busy schedule of activity to prevent being all alone.

G) Show acceptance of the patient’s behavior and of the patient as a person.

FAMILY INTERVENTIONS

Main purpose is to decrease the stress with in family and also relapse.

Education about diagnosis and training in problem solving.

The importance of medication compliance and follow up visits.

Reducing expressions of anger guilt by family members.

Maintenance of reasonable expectation of patient performance.

Encouragement of relatives to set and keep to appropriate limits while maintaining whilst maintaining some degree of separation when needed.

THANK YOU