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Mistrust is a feature of both certain psychotic disorders, for example, paranoid schizophrenia, and some personality disorders, for example, paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder. In some cases the symptoms of those who suffer the above named personality disorders can become so severe that they can suffer brief reactive psychosis, particularly paranoid personality disorder. These people are very wary of others, to the point that they become isolated for fear that others want to harm them in some way. Personality disorders do not respond to psychiatric medications as readily as psychotic disorders do, and in many cases, particularly in paranoid personalty disorder, if the sufferer is in therapy it takes months or years for them to really begin to build trust in a therapist, and they are constantly analyzing everything the therapist says or does, looking for any reason not to trust the therapist anymore.

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