Differential diagnosis Clinicians can usually distinguish paranoid personality disorder from other personality disorders by the pervasiveness of its paranoia regarding others (eg, as opposed to the more transient paranoia of borderline personality) and by the core feature of each disorder: Schizoid personality disorder: Disinterest (as opposed to the mistrust in paranoid) Schizotypal personality disorder: Eccentric ideas, speech, and behavior Borderline personality disorder: Dependency Narcissistic personality disorder: Grandiosity Antisocial personality disorder: Exploitation Avoidant personality disorder: Fear of rejection Paranoid personality disorder can be distinguished from delusional disorder (persecutory type), schizophrenia, and a depressive disorder or bipolar disorder with psychotic features because in these disorders, episodes of psychotic symptoms (eg, delusions, hallucinations) are prominent.