Paranoia is not an affective disorder, and mistrust is not an essential feature of it

In this excerpt from a larger study of paranoia, Bleuler begins with a refutation of Specht’s claims that paranoia arises from a pathological affect of suspiciousness.

Bleuler emphasizes that no one has succeeded in deriving paranoia from a pathological affect and that mood disorders present with phenomena and courses different from paranoia.

Affects appear to be a nonessential component of suspicion. They can vary both qualitatively and quantitatively and are often even absent despite suspicion. Furthermore, it is usually suspicion that generates an affective reaction, not the other way around. Suspicion itself, therefore, cannot be an affective process, but must be an intellectual one.

Finally, paranoia can exist even in the absence of suspicion, and excessive mistrust does not necessarily lead to paranoia. On the contrary, in some cases of paranoia we find associated with suspiciousness an abnormal trust in some other individuals, a phenomenon that Kraepelin described as pathological credulity.

Keywords:

History of psychiatry, Psychopathology, Delusion, Paranoia, Schizophrenia spectrum, Psychosis