Schizophrenia and Other Psychotic Disorders

 These ones mean that the psychotic issues are the main trait of the disorder. If psychosis is a symptom, the disorder will be listed elsewhere. Psychosis is the presence of delusions or hallucination without insight.

Schizophrenia – to be diagnosed with schizophrenia you must of 2 or more of delusion, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms (flat affect, alogia – lack of unprompted content seen in normal conversation, avolition – lack of drive) for at least 1 month. If the delusions are bizarre or the hallucinations are ongoing/constant or is 2 voices talking, schizophrenia can be diagnosed with just one of those symptoms. There must be signs of disturbance for at least 6 months.  Indicators include:

 Episodic w/ interepisode Residual Symptoms (meaning the psychotic symptoms appear at intervals and can additionally add With Prominent Negative Symptoms.

Episodic with no Interepisode Residual Symptoms

Continuous (psychotic symptoms present throughout period of observation and can additionally ad With Prominent Negative Symptoms.

There are also subtypes:

  Paranoid Type – delusions or frequent auditory hallucinations but no disorganized speech, disorganized or catatonic bx, or flat/inappropriate affect

Disorganized Type – disorganized speech, disorganized bx, flat/inappropriate affect are all met and do not meet criteria for Catatonic Type

Catatonic Type – at least 2 of: motor immobility, excessive motor activity (purposeless), extreme negativism/mutism, peculiar movements, echolalia (involuntary repetition of sounds)/echopraxia (involuntary repetition of another person)

                Undifferentiated Type – meets criteria for Schizophrenia but not the other subtypes

Residual Type – absence of delusions, hallucinations, disorganized speech, and disorganized or catatonic bx but continuing disturbance with 2 or more negative symptoms

Schizophreniform Disorder – duration of illness is at least 1 month but less than 6

Schizoaffective Disorder – has Major Depressive, Manic, or Mixed Episode concurrent with delusion, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms and at least 2 weeks have had symptoms w/o mood symptoms

Delusional Disorder – one or more nonbizarre delusions for at least 1 month (Erotomanic Type – thinking someone of a higher social status is in love with self; Grandiose Type – delusions of inflated worth, power, knowledge, identity, or special relationships with someone in a higher social status; Jealous – delusions that significant other is unfaithful; Persecutory Type – delusions that self or close other is being treated badly in some way; somatic Type – delusions that person has physical defect or gen med condition; mixed type – more than one of others; unspecified type)

Brief Psychotic D/o – Criteria for Schizophrenia for at least 1 day but less than 1 month

Shared Psychotic Disorder – sharing in delusions of someone involved in close relationship with another

Psychotic D/o due to gen med condition

Substance-Induced Psychotic D/o

Psychotic d/o NOS

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders Text Revision, 4^th ed. Jaypee Brothers Medical Publishers.