Quick reference
- When to use
- Use F60.0 when the client demonstrates a pervasive, inflexible, and enduring pattern consistent with Paranoid Personality Disorder that deviates from cultural expectations, causes distress or impairment, and is stable over time. Do not assign based on a single clinical encounter.
- Duration
- Personality disorders are enduring patterns — symptoms should be traceable to adolescence or early adulthood. Minimum of several sessions recommended before diagnosing. Reassess periodically as treatment may modify traits.
- Session codes
- Pair with CPT 90834/90837 for individual therapy. DBT programs: 90853 (group), 90834 (individual), plus phone coaching. 90791 for comprehensive evaluation. Long-term treatment is typical.
- Key indicators
- Enduring pattern of inner experience and behavior • Deviates from cultural expectations • Pervasive across situations • Onset in adolescence/early adulthood • Stable and long-standing • Distress or impairment
What F60.0 represents
PPD involves a pervasive distrust and suspiciousness of others. Individuals with PPD interpret others' motives as malevolent and are preoccupied with unjustified doubts about loyalty and trustworthiness.
Key diagnostic criteria
4+ of 7 criteria:
- Suspects exploitation, harm, or deception without basis
- Preoccupied with unjustified doubts about loyalty
- Reluctant to confide due to fear of malicious use
- Reads threatening meanings into benign remarks
- Persistently bears grudges
- Perceives attacks on character not apparent to others
- Recurrent suspicions about partner's fidelity
Documentation essentials
Document pervasive pattern of distrust. Note how it manifests across contexts.
Differential diagnosis
Distinguish from delusional disorder (persecutory type), schizophrenia, paranoid features of PTSD, and cultural norms.
Treatment planning
CBT focusing on cognitive distortions. Building therapeutic alliance is challenging but essential. Avoid confrontational approaches.
Insurance & billing
Accepted code. Document functional impairment from interpersonal distrust.
Updates & changes
May be reconceptualized in future dimensional personality models.
Documentation pitfalls
Consider cultural context. Don't pathologize appropriate caution or vigilance based on lived experience.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).