The Paranoid

H. Keith Fischer, MD
JAMA. 1971;215(5):800. doi:10.1001/jama.1971.03180180074029.
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The chief contribution of this book about paranoids and paranoia is its focus on the topic as a syndrome—a constellation of traits and symptoms that constitute a spectrum of paranoid phenomena ranging from relatively minor patterns in seemingly "normal" individuals, to paranoid psychoses. The "paranoid mode of thinking," the paranoid "outlook" or "slant on life," is the basis of the authors' point of view. They observed this in individuals, families, citizens, groups, in relationship to the law, education, medicine, government, religion, racism, and history—in almost everyone, some of the time, and almost everywhere.

This focus rests basically on description. It emphasizes characteristics of projective thinking, hostility, suspiciousness, centrality, delusions, fear of loss of autonomy, and grandiosity. The authors, observing the paranoid mode of thinking in a large group of major and minor clinical entities and as a complication of other syndromes, discuss biological, psychological, and social factors. Yet these comprise


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