Hi, I fixed the article and removed the text in question as per your criticisms.

Paranoia is not a psychotic symptom. There are varying degrees of paranoia, which differ in terms of intensity from obsessional to overvalued ideas to ideas of reference all the way to delusions. Whether or not paranoia is a delusion has to do with the intensity of belief and frankly the specificity of the belief. Thought disorder in Cho I felt was due to autism. Thought disorder in psychosis usually refers to schizophrenia and has a characteristic look - which Cho lacked. It is also present in mania, but it looks a lot different - Cho did not have manic thought disorder. It's not necessarily present in other types of psychosis at all. FWIW, autistics have their own type of thought disorder. I'm with you on being cynical about p-docs (drug pushers) and drug companies (drug cartels). Thing is, only drugs have worked for me...

I am sorry, Robert, but I am going to disagree with you about the paranoia. Paranoia can be a symptom of psychosis. It can take the form of a delusion (ok then in that case, not psychosis) like in delirium, a thought insertion (psychosis), thought content (psychosis), hallucination both visual and/or auditory (psychosis), or paranoid thinking. Paranoid thinking DOES NOT NECESSARILY IMPLY PSYCHOSIS, and it can be a symptom of many other disorders from personality (paranoid personality to hypomania, mania and substance induced disorders - think amphetamine/stimulant intoxication.

I think that paranoia is NOT only a symptom of psychosis and schizophrenia. Maybe that is what you meant after all. If so, then we are in agreement.

Cheers...
Dr. BK

You just got "Oppositional Defiant Disorder".

David Rovics made a blues grass song of it, give it 30 seconds if you listen to it. The begining doesn't flow too well, but the chorus is good.
http://www.archive.org/download/David_Rovics_11-28-2006_1000_Fryd_Alborg/dr2006-11-28d1t14_64kb.mp3

Oppositional Defiance Disorder
David Rovics

Alex is a member of my record label
Teenager though he is
He joined the Ever Reviled Records collective
And the indy music biz
Well his parents didn't like such turns of events
So they sent off a couple of thugs
To bring him back to Utah, lock him up
And pump him full of drugs
They say he's got problems with authority
Yes this is what they claim
And their psychiatric analysis
Has even got a name

(Chorus)
Oppositional Defiance Disorder
I think I got it, too
Oppositional Defiance Disorder
He's sick and so are you

If you think George Bush is a moron
And Tony Blair's a liar
If you fantasize about setting
Your local Wal-Mart on fire
If you don't like Tom Brokaw
And you think he's full of it
And you feel that a Rush Limbaugh punching bag
Might be kinda fun to hit
If bombing other countries
Makes you feel appalled
You have got a problem
And this is what it's called

(Chorus)

If you think school is boring
And your teacher is a fool
If you don't like your congressman
And you called him a corporate tool
If you were not standing
To sing save the Queen
If you turned down hamburgers
And ate rice and beans
We've got a diagnosis
No matter whether you agree
Just do what the doctors tell you
And thank God for psychiatry

(Chorus)

Better link with better audio quality song here to Oppositional Defiance Disorder David Rovics
http://www.soundclick.com/pro/view/01/default.cfm?BandID=111310&content=lyrics&SongID=1122865

I meant that paranoia is not a de facto psychotic symptom. Delusion is, pretty much. As you noted, paranoia can be present to varying degrees in many different disorders, and many paranoid people are not psychotic at all.

I still say, "the world is mean and cruel and I hate the world and I'm going to kill people" is not a delusion, it's just a point of view. A messed up POV, sure, but a POV nonetheless. It's basically a matter of opinion. He says the world is mean and cruel, you and me say it isn't. It's almost a philosophical matter.

I get tired of psychiatry always trying to extend its damn DSM into every nook and cranny of human existence, including matters of sociology, philosophy, etc.

I 100% agree with there is a difference between a warped POV and psych dx.

I get tired of psychiatry always trying to extend its damn DSM into every nook and cranny of human existence, including matters of sociology, philosophy, etc.
Or you could also say that philosophy and sociology and theology extends themselves into psychiatry. All "soft" sciences trip all over themselves. Camus wrote some lovely words on suicide that I hold to be way more valuable than anything I've read in psychiatry/psychology. And vice versa.

I almost think Camus' The Stranger explains this Cho guy about as well as anything else, you know?

Regarding Cho, not only did he think the world was mean and cruel and therefore he ought to shoot it up, but also he blew his own brains out. I still say he was delusional to do this. He also dressed up for the occasion and produced a slew of videos and writings. I don't call this just having a POV about the world. I call it going mad and becoming seriously disconnected from reality (one way in which I define psychosis). As for the DSM I'm certainly not in favor of using that to explain anyone's behavior or worse to determine their "treatment" but that doesn't mean craziness, psychosis and madness aren't out there in spades.