Psychotic Disorders

Psychotic Disorder

Loss of contact with reality — hallucinations, delusions, disorganized thinking.

Delusional Disorder

One or more non-bizarre delusions lasting ≥1 month functioning not markedly impaired.

Brief Psychotic Disorder

Sudden onset of psychotic symptoms (delusions, hallucinations, disorganized speech) lasting <1 month, full recovery.

Schizophreniform Disorder

Schizophrenia-like symptoms lasting 1-6 months.

Schizophrenia

≥6 months of psychotic symptoms (delusions, hallucinations, disorganized speech/behavior, negative symptoms).

Schizoaffective Disorder

Symptoms of schizophrenia + mood disorder (depressive or manic episodes).

Delusions

fixed false beliefs not based on reality

Persecutory Delusion

belief that others are trying to harm, cheat, spy, or plot against you.

Referential Delusion

belief that random events, gestures, or comments are directed at you personally.

Grandiose Delusion

belief that you have great talent, power, wealth, or fame.

Erotomanic Delusion

belief that someone (often of higher status) is secretly in love with you.

Nihilistic Delusion

belief that something terrible or catastrophic will happen or that the world no longer exists.

Somatic Delusion

false belief about one's body (e.g., "My organs are rotting").

Jealous Delusion

false belief that your partner is being unfaithful.

Bizzare Delusions

beliefs that are clearly impossible or illogical (e.g., "Aliens replaced my brain").

Hallucinations

False sensory experiences that seem real but happen without an actual external stimulus.

They can affect any sense, but hearing voices (auditory _) is most common.

Auditory Hallucination

hearing voices or sounds that aren't real.

Visual Hallucination

seeing people, lights, or shapes that aren't there.

Olfactory Hallucination

smelling things that aren't present.

Gustatory Hallucination

tasting something without food or drink.

Disorganized Thinking (Speech)

Difficulty organizing thoughts logically, which shows up in the way a person talks.

Their speech may sound confusing or jump between unrelated ideas.

Derailment / Loose Associations

shifting from one topic to another with no clear link.

Tangentiality

giving answers that are off-topic or unrelated.

Incoherence / "Word Salad"

speech is jumbled and incomprehensible.

Grossly Disorganized or Abnormal Motor Behavior

Unusual, purposeless, or unpredictable physical actions that interfere with daily activities.

Catatonia

a severe form of motor disturbance — may include staying still for long periods, mutism, or repetitive movements.

Negative Symptoms

A loss or decrease of normal emotional and behavioral functions. These make a person seem emotionally flat, unmotivated, or withdrawn.

Diminished Emotional Expression

reduced facial expressions, gestures, and voice tone.

Avolition

lack of motivation to start or continue purposeful tasks.

Alogia

limited or brief speech.

Anhedonia

inability to feel pleasure from activities once enjoyed.

Asociality

lack of interest in social interaction.

Substance/Medication-Induced Psychotic Disorder

Delusions/hallucinations caused by drugs or withdrawal.

Common substances: alcohol, cannabis, hallucinogens, stimulants.

Risk factors: high dose, frequent use, older age, family history.

Treatment: stop the substance, antipsychotics, benzodiazepines, psychosocial support.

Psychotic Disorder Due to Another Medical Condition

Psychosis from medical illness (e.g., epilepsy, stroke, infection).

Course: may be transient or chronic.

Treatment: treat underlying condition + antipsychotics, supportive care.

Catatonia (Specifier or Separate Disorder)

≥3 motor symptoms: stupor, mutism, posturing, waxy flexibility, echolalia, echopraxia.

Can appear with schizophrenia, mood disorders, or medical causes.

Treatment: benzodiazepines (lorazepam), ECT, supportive care.

Other Specified Schizophrenia Spectrum and Other Psychotic Disorder

Symptoms cause distress but don't meet full criteria.

Clinician states the reason (e.g., "persistent auditory hallucinations").

Treatment: antipsychotics, psychotherapy, social support.

Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

Used when there's not enough information (e.g., in emergencies).

Treatment: stabilization, antipsychotics, follow-up evaluation.