Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Paranoia.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- May need to get some history from family members and friends. Paranoid people are most likely to present following requests by family and friends. Paranoid people are by nature suspicious of others and they do not often present voluntarily for care
- How long have you noticed the paranoia?
Why: to determine if acute or chronic. If acute in nature must consider delirium or a new onset of psychiatric illness as a possible cause of delusion. Delirium is an acute confusional state due to many causes e.g. infection, drug intoxication, alcohol withdrawal, hypoxia (reduced oxygen levels in the blood), stroke or head injury. If the onset is chronic a diagnosis of a psychiatric illness or dementia may be more likely.
- What are the symptoms and features of the paranoid thoughts?
Why: e.g. general suspiciousness; fears and beliefs that they are being persecuted, taken advantage of, or wronged in some way; inability to trust or confide in others; hostility if it is perceived that others are prying or scheming against the person; reluctance to sign any sort of paper work; excessive concern about confidentiality; refusal to accept medication or other forms of treatment due to suspiciousness or lack of trust in the clinician's motives; history of repeated terminations of employment.
- How would you describe the person's personality?
Why: Paranoia may be a personality trait characterized by social isolation, hypersensitivity and suspiciousness that may lie inside or outside the range of "normal" behavior. People are diverse and some people have more paranoid beliefs or beliefs in conspiracy theories than other people.
- Was there a known precipitating factor to the paranoid thoughts and behavior?
Why: e.g. physical illness, starting a different medication, abstaining from alcohol. Paranoid thinking is likely to be heightened by stress.
- History of head injury?
Why: Paranoid thinking may occur in association with brain injury.
- Past psychiatric history?
Why: Paranoia may be one of the many difficult symptoms associated with a diagnosed mental disorder such as schizophrenia, bipolar affective disorder, paranoid delusional disorder, paranoid personality disorder or schizotypal personality disorder.
- Family history?
Why: e.g. dementia, Alzheimer's disease, Huntington's disease, schizophrenia, bipolar affective disorder, depression and prophyria.
- Alcohol history?
Why: to assess chance of alcohol withdrawal, alcohol abuse or head injury.
- Illicit drug use history?
Why: Abuse of stimulant or hallucinogenic drugs such as amphetamine, marijuana, cocaine, LSD, PCP may cause paranoid thinking and may also precipitate acute psychosis.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Memory loss?
Why: Paranoia may be the presenting feature in dementing elderly people.
- Persecutory delusions?
Why: include beliefs that centre around the theme that you are being deliberately wronged, or conspired against, or harmed by another person or agency. Such beliefs are often associated with schizophrenia.
- Delusions of jealousy?
Why: belief, without good reason, that your partner is unfaithful. May be associated with Delusional disorder.
- Hallucinations?
Why: false sensory perception in which you see, hear, smell, sense or taste something that other people do not see, hear, smell or taste. Auditory hallucinations may occur with schizophrenia, bipolar affective disorder, dementia or delirium, and their content tends to be related to the nature of the disorder. Visual hallucinations are most common with delirium.
- Psychotic symptoms?
Why: e.g. delusions, hallucinations and disordered thinking - may suggest schizophrenia or bipolar disorder but these symptoms may also be present with delirium, dementia and severe depression.
- Symptoms of paranoid schizophrenia?
Why: e.g. persecutory delusions (beliefs that centre around the theme that you are being deliberately wronged, or conspired against, or harmed by another person or agency) accompanied by auditory hallucinations (false sensory perception in which you hear something that other people do not hear).
- Symptoms of paranoid personality disorder?
Why: e.g. excessive sensitivity to humiliations and rebuffs; a tendency to misconstrue neutral or friendly actions of others as hostile and contemptuous. They may be prone to jealousy or excessive self importance. These people bear grudges and are unforgiving.
- Symptoms of dementia?
Why: e.g. impaired memory, impaired judgement and thinking, impaired verbal fluency and impaired ability to perform complex tasks. Personality may change, impulse control may be lost and personal care deteriorates. People with dementia may also have psychiatric symptoms such as delusions, paranoid ideas, hallucinations, mood disturbance and behavioral disturbance. Paranoia may be the presenting feature in dementing elderly people.
- Symptoms of delirium?
Why: e.g. impaired conscious level with onset over hours or days, disorientation in time and/or place, unusually quiet, drowsy, agitated, delusions, auditory hallucinations, visual hallucinations.
» Next page: Types of Paranoia
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