Welcome to website on Kretschmer’s sensitive paranoia and related disorders

Objective :

This website has been created to inform people with mental disorders and their family and friends about the disease described by Kretschmer in order to relieve their suffering.

This website is intended for patients : In the personality traits described, they may recognize themselves and their disorder or the way in which they “judge” other people when they encounter setbacks in their lives.

This website is intended for their family and friends : As we will see, support from family and friends throughout the course of the disorders is very important in many domains to facilitate improvement of the patient’s state. In particular, they must provide the patient with attention and affection despite his/her behaviour, which can sometimes be difficult to bear.

Regular follow-up by a psychiatrist is essential : Close collaboration between the psychiatrist, the patient and family and friends help to accelerate progress.

What is Kretschmer’s sensitive paranoia?

Subjects with Kretschmer’s sensitive paranoia are extremely sensitive. Their disorders were demonstrated and described by the German psychiatrist Ernst Kretschmer (8 October 1888-8 February 1964). He described a set of personality traits common to these subjects by the term “sensitive personality”. These disorders are a sensitive form of paranoia, also known as “sensitive paranoia” or “hypersensitivity”.

Subjects with this personality disorder may gradually develop, generally following a humiliation or disappointment, a delusional state, the most frequent form of which is called “sensitive delusions of reference”.

The consequences of this disease are very disturbing for the patient and for the patient’s family and friends: work problems, emotional distress, ruminations, solitude, affective and family ruptures, dangerous behaviour, suicidal risk, particularly during acute depressive episodes.

These disorders are often difficult to diagnose because they are uncommon, polymorphous, highly variable from one individual to another, and readily attributed to other disorders.

Sensitive paranoia, as described by E. Kretschmer, is fairly uncommon, but it is not rare. In the last version (1950) of his book “Paranoia and Sensitivity”, Kretschmer wrote: “On the basis of our long experience, we have formed a fairly clear opinion on the frequency of sensitive delusions of reference… At the Tübingen clinic, we see an average of one or two definite cases of sensitive delusions of reference per year”. However, cases of sensitive personality or sensitive neurosis are more numerous.

Changing concepts of sensitive paranoia

Sensitive paranoia is a disease with a fairly well defined central core, but with relatively vague contours. E. Kretschmer himself emphasized the fact that there were no clearly defined limits between sensitive paranoia and other mental disorders. At that time, the emergence of delusions was often related to inner conflicts between ethics and sexuality. These delusions occurred in a society bound by guilt-ridden sexual morality. The subjects of these delusions are now more diverse, but always tinted with judgemental moralism.

Since Kretschmer’s description in 1919, many psychiatrists and scientists have studied and analysed the concept of sensitive paranoia. Neuroleptics and antidepressants had not yet been discovered at that time and the introduction of these drugs into psychiatric treatment in 1952 led to a revision of the basic concepts.

G. CHARBONNEAU indicated [1] that “sensitive paranoia is uncommon in its historical form described by E. Kretschmer. This description may appear to be somewhat dated, as it expressed certain characteristics of the moral discourse of his times, both in terms of community integration and freedom of sexual behaviour. However, this disease is much less rare in its fragmented, minor forms, or even repeated forms (Kretschmerian themes that appear and disappear, but that are rarely revised). Sensitive paranoid elements are very regularly encountered in the context of depression, and especially in refractory depression involving personality traits. This sensitive paranoia usually presents in the form of chronic depressive disorder, combining chronic lethargy and ruminations”.

Related disorders

R. ARNAUD-CASTIGLIONI, J.-C. FISHER, P. RAYMONDET, P. CALVET, J. C. SCOTTO have described [2] « unstable delusions » occurring in subjects with sensitive personality disorder, but which can correspond to chronic hallucinatory psychoses. These unstable delusions are similar to acute dissociative delusions, another clinical form of sensitive paranoia described by Kretschmer, but which is less frequent than delusions of reference. They respond to antidepressants.

Drug treatment

Specific treatment prescribed by a psychiatrist is absolutely necessary. Effective drugs are available (antidepressants, neuroleptics, etc.), but treatment must be prescribed very cautiously and must be carefully evaluated. Psychotherapy is also highly recommended.

1. Approche phénoménologique de la paranoïa  sensitive de E. Kretschmer. Le cas Edgar Charles. Pratiques psychologiques. 2007.Fasc : 2. Pages 153-167
2. Les délires instables, Psychologie médicale,1988, 20,10,. Pages 1431-1433