A 45-year-old man is suspicious that colleagues at work are exploiting him, questions the loyalty of close friends, reads demeaning meanings into neutral remarks, and holds long-lasting grudges. He has no history of psychosis. The personality disorder cluster and specific diagnosis is:

• A Cluster B; Narcissistic personality disorder
• B Cluster A; Schizoid personality disorder
• C Cluster A; Paranoid personality disorder ✓
• D Cluster C; Avoidant personality disorder

Explanation

Paranoid personality disorder belongs to Cluster A (odd/eccentric cluster, which includes schizoid and schizotypal personality disorders). Core features are pervasive distrust and suspicion of others' motives, interpreting neutral actions as threatening, reluctance to confide due to fear of betrayal, and bearing grudges. Unlike schizophrenia, there are no fixed delusions or hallucinations. Cluster B (dramatic/emotional) includes antisocial, borderline, histrionic, and narcissistic PDs. Cluster C (anxious/fearful) includes avoidant, dependent, and obsessive-compulsive PDs.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.