Psychotic Disorder

Psychotic Disorder


Types of HallucinationsAuditory
Auditory HallucinationsOften psychiatric
Voices very common
Indistinguishable sounds
Visual HallucinationsPoorly defined/symbolic: Usually psychiatric
Well formed (people, animals): Usually medical
Tactile hallucinationsOften medical/delirium
Bugs, picking, phantom
Olfactory/gustatoryoften neurological

DelusionA false belief:
Based on an incorrect inference of external reality.
Firmly held despite clear evidence to the contrary.
Not accepted by other members of the person’s culture.
loose associationsdisorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts
BlockingA failure to retrieve information that is available in memory even though you are trying to produce it
Ideas of referenceoften seen in paranoid patients; they personalize unrelated events EXAMPLE: see the nurse talking to the therapist and think they are talking about him/her.
Thought BroadcastingFeeling that one’s thoughts are being broadcast or projected into the environment
Neologismnew word or expression
Echolaliaan autistic symptom in which the person “echoes” or repeats what has just been said
Clang associationassociation of words similar in sound but not in meaning; words have no logical connection; may include rhyming and punning
EchopraxiaThe meaningless imitation of another person’s movement
catatoniaa state of unresponsiveness to one’s outside environment, usually including muscle rigidity, staring, and inability to communicate
negativismDoing the opposite of what others want
stereotypicalrepetitive speech or action
mutismInability or refusal to speak

Brief Psychotic Disorder

  • Presentation:
    • 1 day up to <1 month
    • The episode lasts at least one day but less than one month, and the individual eventually has a full return to the premorbid level of functioning.
    • A disturbance that involves the sudden onset of at least one of the following positive psychotic symptoms:
    • delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior.

Schizophreniform Disorder

  • Presentation:
    • Same criteria for Schizophrenia, but total duration is > 1 month, but < 6 months.
    • Often rapid onset.
    • Prognosis is better.
  • Treatment:
    • Treated with antipsychotics, but may not need long term.
    • Tx: similar to bipolar or major depression


Schizoaffective Disorder

  • Presentation:
  • Diagnosis:
    • Patient has periods (2 weeks or more) of psychosis occurring during times when they are not manic or depressed.

Delusional Disorder

  • Presentation:
    • 1+ Non-bizarre delusion for 1 month or more
    • Delusions of at least 1 month duration.
    • If hallucinations present, they are not prominent and are related to delusion.
    • Specify whether delusion is bizarre.
    • might seem normal or lack of negative symptoms
  • Types:
    • Erotomanic (someone else loves them)
    • Grandiose
    • Jealous (partner unfaithful)
    • Persecutory
    • Somatic (has illness/defect)
    • Mixed or unspecified
  • Treatment:
    • often not effective; can be chronic

Shared psychotic disorder / Folie a deux


  • Presentation:
    • New onset psychosis in an older person with no history of a primary psychotic disorder is strongly suggestive of dementia and/or delirium
    • Delirium: Visual+tactile hallucinations.
    • Dementia: Visual hallucinations+delusions.
  • Common causes of delirium-related psychosis:
      • –Infection (UTI, pneumonia)
      • –Medication side effect
      • –Stroke
      • –Any change in medical status

Post-Partum Psychosis

Show Buttons
Hide Buttons
error: Content is protected !!