Full-blown paranoid syndrome is constantly combined with increased activity. Patients with expansive delusions usually experience an open struggle for their imaginary rights and achievements. In such a struggle, patients are able to induce other people, primarily from among those in their immediate environment. In patients with paranoid delusions, such a struggle is often hidden and can end in a sudden attack on imaginary opponents. Delusional behavior in paranoid syndrome usually indicates a fairly systematized delusion.

Patients with paranoid syndrome are characterized by thoroughness of thinking - the so-called delusional thoroughness, which is most clearly manifested when presenting the content of delusional ideas. Paranoid delusions are generally difficult to treat.

PARANOID SYNDROME occurs most often and is characterized by unsystematized polythematic delusions, combined with deceptions of perception (most often in the form of verbal, less often olfactory or tactile hallucinations) and, often, with certain phenomena of mental automatism. The content of delirium contains ideas regardingia, persecution, poisoning, damage, external influence, sometimes ideas of witchcraft, damage, in some cases hypochondriacal. The theme of delusions, the content of hallucinations and the nature of mental automatisms are closely related. This syndrome is observed both in acute psychotic attacks (acute paranoid) and in chronic mental illnesses. Paranoid syndrome can occur against the background of altered depressive mood or anxiety and be accompanied by delusional ideas of the corresponding content. In such cases, they speak of depressive-paranoid or anxiety-paranoid syndromes.

The core of the mental picture is a variety of mental automatisms (mental, sensory, motor), combined with delusions of physical or mental influence. The first comprehensive description of the symptomatology of this disorder belongs to V.Kh. Kandinsky (1885). In the works of G. de Glerambault (1920-1926), a classification was given of the previously identified V.Kh. Kandinsky symptoms and combined them into a syndrome. There are three types of mental automatisms.