The factors to which the pathogenesis of paranoia is ascribed are pred
isposition, personality and environment. This paper deals with further
etiological preconditions such as psychoorganic impairment, convulsiv
e disorders and physical handicaps together with their psychoreactive
processing, based on detailed case reports. Such patients are relative
ly frequent within the (epidemiologically small) group comprising para
noia. The psychodynamic factors underlying the sensitive processing of
physical handicaps are described, with means of prevention being disc
ussed in conclusion.