The ‘group A’ (paranoid, schizoid and schizotypal) personality disorders

Not only do Group A personality disorders have to be differentiated from the delusional disorders, but it has already been noted in Chapter 7 that they may be on a continuum (‘the paranoid spectrum’) with these disorders. This may involve consideration of premorbid personality patterns in delusional disorder patients, as well as abnormalities of personality in the close relatives of patients with schizophrenia and related disorders. Kendler and Gruenberg (1982) found that paranoid personality disorder was relatively frequent in the families of individuals with ‘schizophrenic spectrum’ conditions (which would include delusional disorder). Kendler and colleagues (1984) noted that schizophrenia-related personality disorders were more common in the first degree relatives of schizophrenics compared with those of normal controls. The present author (Munro, 1982) reported that 28 per cent of a group of 50 delusional disorder, somatic subtype, cases were regarded as having longstanding personality disorders, mostly of a schizoid type. Thirty per cent of the same group described psychiatric problems in close relatives, mostly related to personality factors or alcohol abuse, but with no further details. Winokur (1985) found that the close relatives of 29 nonhallucinating delusional disorder patients showed an excess of suspicious, secretive or jealous personality features and, in a proportion of cases, actual delusions.