Hypotheses are of the vaguest. There may be an excess of premorbid personality disorder, especially of paranoid and schizoid types. There do not appear to be close genetic links with schizophrenia or major mood disorder. The delusional system can appear suddenly or insidiously and often for no obvious reason, although previous alcohol and other substance abuse and a prior history of head injury may be significant. The psychoanalytic view of 'paranoia' is largely based on the persecutory subtype, but the provenance of cases in that literature is usually vague and speculation far outweighs verifiable fact.

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