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What is Paraphrenia?

By Andy Josiah
Updated: Mar 03, 2024

Paraphrenia is a mental disorder, or psychosis, that involves a single delusion or a collection of delusions. This can be related to feelings of grandeur, jealousy or persecution. It is considered a form of schizophrenia, although there are notable differences between the two conditions. Several other terms for paraphrenia exist, which include paranoic type schizophrenia, paranoid schizophrenia, paraphrenic schizophrenia, atypical psychosis, schizoaffective disorder and delusional disorder.

German psychiatrist Karl Ludwig Kahlbaum is credited with coining the term, drawing from the Greek words "para" meaning "beyond" and "phren" meaning "mind." He used it to describe and differentiate certain forms of mental disorders, which included paraphrenia hebetica for adolescents and paraphrenia senilis for elderly patients. It lapsed from significant use in the medical world until 1919, when another German psychiatrist, Emil Kraepelin, lumped a small group of cases under the umbrella of this particular psychotic illness. He published his findings in the four-volume treatise Dementia Praecox and Paraphrenia. Swiss psychiatrist Paul Eugen Bleuler suggested that the term "schizophrenia" should replace "dementia praecox," thereby establishing two different disorders.

In his writings from 1913 to 1917, the Austrian neurologist Sigmund Freud theorized that paranoia, which constitutes delusions with or without grandeur, should be treated as a mental disorder apart from schizophrenia. He held to this theory even when paranoia blurred the line between paraphrenia and schizophrenia. Such an assertion has barely been challenged ever since.

The separation of paraphrenia from schizophrenia is based on patients of the former having the ability to act in a relatively normal manner and exhibit no signs of intellectual decline. Also, unlike schizophrenia, people afflicted with paraphrenia can have and maintain a level of comfort and connection with other people. Notably, though, this disorder has schizophrenic-like characteristics.

The most common symptom of paraphrenia is delusions, which involve holding thoughts or beliefs that are not true. Confabulation, an unrestrained speech of events that never took place, is also common. Additionally, intrusive thoughts can appear without warning or invitation and grow into annoying, unpleasant and indelible obsessions.

By the late 1990s and early 2000s, paraphrenia was most commonly documented in Spain and Germany. Still, there had been no systematic research on the disease since the time of Freud. The psychosis is rarely diagnosed. Also, it lacks a listing in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which specifically serves as the publication for the classification of mental diseases; and in the International Classification of Diseases (ICD), which provides codes for a vast array of medical conditions.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.

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Discussion Comments
By JaneAir — On Nov 10, 2011

@KaBoom - That sounds like delusions of grandeur to me for sure!

Anyway, one thing that's interesting about this disease is it usually doesn't set in until people are a bit older, at least over 40. However, I know schizophrenia tends to set in when people are in their mid twenties. I wonder why there is such an age difference here?

But like the article said, paraphrenia and schizophrenia aren't the same thing. Most people with schizophrenia can't lead normal lives without treatment. However, a person with paraphrenia will usually seem pretty normal, until they start mentioning their delusions.

By KaBoom — On Nov 09, 2011

I used to work at a bar, and I feel sure one of our semi-regular customers had this disorder, or at least paraphrenia symptoms. He mostly seemed normal, except that he told everyone he was a duke and had a ton of delusions of grandeur.

If you sat and talked to him, he would tell you how famous he was, how he was royalty, owns a newspaper, knows the queen of England, and flew a fighter jet in World War II (the man was clearly American and not old enough to have been in World War II.)

I'm not sure who he actually was, but he did indeed have a lot of money. He always spent hundreds of dollars when he came into the bar.

By Oceana — On Nov 09, 2011

For awhile, I thought that my boyfriend was just super jealous. As things got weirder, I began to see that he had a psychotic disorder.

He got mad at me for talking to other guys. I could deal with that. However, he started making up scenarios that did not happen, and I knew something was wrong in his mind.

He told me that he saw me making out with a guy in the park the night before. I reminded him that we were together that night, but he insisted he saw me sitting in the guy's truck in a red sweater. I argued with him, and he called me a liar.

I didn't feel safe in that relationship, so I left. Until reading this article, I didn't know what condition he had. Now I see that his behavior matched the symptoms of paraphrenia.

By lighth0se33 — On Nov 09, 2011

I had a boyfriend with paraphrenia, but I did not know it until we had been dating for three months. He seemed so nice and normal.

One day, we were having a serious conversation about our future, when he suddenly started talking about getting rid of possums. I thought he was just trying to change the subject because the topic made him nervous, but in just a moment, we were talking about us again.

When I came over to his house that evening, he was researching ways to trap possums. He said they were all in his attic, and he could hear them dancing around while he tried to sleep.

He became absolutely obsessed with eradicating the imaginary possums. It didn't matter that the exterminator he hired told him there were no possums in that part of the country. It fueled his obsession more.

I could not force him to get treatment. I pleaded with him, but he said flat-out, “I'm not crazy. I have possums.” Unable to deal with his possum obsession for the rest of my life, I broke up with him.

By seag47 — On Nov 08, 2011

@wavy58 – It's sad to me that the town turned away from this woman. She obviously had a mental condition and needed treatment.

My grandmother had paraphrenia, and she remained likeable and mentally aware until the day she died. Her only problem was that she had vivid memories of things that did not happen.

She would try to get us grandchildren to recall the time that such and such occurred, and we would tell her that it never happened. Then, she would go into a detailed description of where we were, what was said, and even what we were wearing at the time.

I was always amazed at how her mind could confabulate these situations. She should have been a writer or a storyteller.

By wavy58 — On Nov 07, 2011

I believe that my elderly neighbor had paraphrenia. Most people around town just said she was getting senile, but I knew that it wasn't that simple.

She could still take care of herself. She could drive, buy groceries, and even throw parties. Her delusions of grandeur are what scared people away and made them think she was crazy.

She told everyone that she was a wealthy princess of some country no one had ever heard of, because I think she made up the name. She always tried to make people believe she was wealthy and important, but anyone could see that her belongings were ordinary.

She talked about her precious jewels, which anyone could see were just costume jewelry. She put out her “fine china,” but we all knew that you could buy those plates at the local supermarket for $20 a set.

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