Psychotic Disorders

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Psychotic disorders are a group of severe mental health conditions characterized by psychosis or a significant loss of contact with reality. It involves disturbances in thinking, perceptions, emotions, and behavior, making it difficult to distinguish between real and imagined experiences. Psychotic disorders are treatable conditions, and early intervention is associated with better long-term outcomes. Treatment is typically a combination of antipsychotic medication (helps control symptoms), cognitive behavioral therapy (CBT) (develop coping skills), and support services. Core symptoms are categorized as positive (added experiences) and negative (reduced/absent normal functions).

POSITIVE SYMPTOMS:

  • Hallucinations are false sensory perceptions (hearing voices, seeing images, feeling sensations that aren’t there). Auditory hallucinations are the most common.
  • Delusions are strongly held, false beliefs resistant to change, even when presented with contrary evidence. Common types: persecutory (believing one is being plotted against), grandiose (believing one has special powers), and referential (believing TV or news is sending personal messages).
  • Disorganized thinking/speech results in incoherent, illogical, or “word salad” speech or abruptly stopping mid-sentence.
  • Disorganized or abnormal motor behavior leads to unpredictable, inappropriate actions, ranging from agitation to catatonia (state of immobility and unresponsiveness).

NEGATIVE SYMPTOMS:

  • Diminished emotional expression, like flat/monotonous voice, reduced use of facial expressions, lack of emotional display.
  • Lack of motivation (avolition), reduced ability or complete lack of desire to start or complete goal-directed activities, including basic self-care.
  • Social withdrawal from family, friends, and social situations.

PSYCHOTIC DISORDER TYPES: DSM-5 groups psychotic disorders by type and duration:

  • Schizophrenia: Chronic condition lasting 6 months or longer, involving both psychotic symptoms and significant functional impairment.
  • Schizoaffective disorder: Symptoms of schizophrenia with a co-occurring mood disorder, such as depression or bipolar disorder.
  • Brief psychotic disorder: Sudden, short episode of psychosis, lasting less than 1 month, often triggered by major stressor or trauma.
  • Delusional disorder: Persistent, non-bizarre delusions (plausible but untrue beliefs) for at least one month, without other prominent psychotic symptoms.
  • Schizophreniform disorder: Schizophrenic symptoms, but lasts 1-6 months.
  • Substance/medication-induced psychotic disorder: Psychosis directly caused by use or withdrawal.
  • Psychotic disorder due to another medical condition: Psychosis caused by brain tumor, infection, or neurological disorder

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