A 46-year-old male blue-collar worker was first admitted to the psychiatric hospital after attempted suicide. In his teenage years, he had been hospitalized for head trauma with brain concussion after a traffic accident. Also, he had long-standing alcohol abuse. After detoxification, he was described as vulnerable, self-insecure, self-referent, very sensitive, touchy, suspicious, and mistrustful. The most prominent trait, however, was jealousy, especially in regard to his wife’s fidelity. Repeatedly, she was accused of miscellaneous matters and “interrogated” about diverse idiosyncratic issues. Alcohol intake consistently resulted in a marked accentuation of the paranoid pattern. During 3 inpatient admissions and 22 outpatient sessions, recurrent depressive symptoms were observed. However, no episode of clear-cut delusion formation was ever registered. No further cognitive impairments could be established, and so no brain imaging was performed. The patient had taken a variety of antidepressants, antipsychotics, and disulfiram, although, at last discharge, diagnosed with “paranoid personality disorder” and “episodic alcoholism,” there was no major clinical change.