Diagnosis and management of the paranoid patient

Patients with symptoms of paranoia often present to primary care physicians. The paranoia may range in severity from a mild and largely incidental finding to a psychotic symptom. In its more severe forms, paranoia may constitute the chief complaint or may interfere with the patient's ability to accept treatment for other medical conditions. After an assessment of the severity of the symptoms and consideration of an organic etiology, initial treatment is often begun with a supportive approach and the prescription of a neuroleptic medication.