Factors associated with paranoid symptoms in a community sample of older adults.

Symptoms of paranoia were found in 9.5% of a community sample of older adults in North Carolina. In cross-sectional analyses, these symptoms were associated most strongly with black race, lower income and education, less exercise, and more depressive symptoms. In longitudinal analysis, paranoid symptoms three years following initial interview were predicted by baseline paranoid symptoms, education and depressive symptoms at the initial interview. In blacks, paranoid symptoms may represent an appropriate response to a hostile environment rather than a psychopathic trait.