DSM V-TR Delusions, Hallucinations, and Other Psychotic Symptoms

Delusions, hallucinations, and other psychotic symptoms are briefly defined.

Delusions

Fixed beliefs that will not change despite evidence.

Persecutory delusions

False and persistent beliefs that one is being pursued, harassed, or stalked by individuals or groups.

Referential delusions

The belief that certain circumstances are associated with the individual, when it is not.

Somatic delusions

Beliefs centered on health and organ functioning

Nihilistic delusions

The belief that a major catastrophe is imminent.

Grandiose delusions

The belief that one holds a special power, unique knowledge, or is extremely important

Erotomanic delusions

The belief that one person is in love with him or her.

Hallucinations

Perception-like experiences that occur without an external stimulus

Disorganized thinking

Formal thought disorder that includes derailment, tangentiality, or incoherence

Depressive delusions

Guilt, poverty, nihilism/death, and illness

Passive delusions

Thought-broadcasting or insertion, thought withdrawal, and insertion of impulses or feelings

Grossly disorganized/abnormal motor behavior

Ranges from childlike silliness to unpredictable agitation; may include catatonic behavior

Negative symptoms

diminished emotional expression, avolition, alogia, anhedonia, asociality, attentional impairment

Catatonia specifier

The clinical picture is dominated by three (or more) of the following symptoms:

1. Stupor (i.e., no psychomotor activity)

2.Catalepsy (i.e., Examiner can move the person and they stay there)

3.Waxy flexibility (i.e., Resistance when examiner moves them)

4.Mutism (i.e., no, or very little, verbal response)

5.Negativism (i.e., opposition or no response to instructions or external stimuli).

6.Posturing (i.e., the individual assumes the position)

7.Mannerism (i.e., odd, circumstantial caricature of normal actions).

8.Stereotypy (i.e., repetitive, abnormally frequent, non-goal-directed movements).

9.Agitation, not influenced by external stimuli.

10.Grimacing.

11.Echolalia (i.e., mimicking another's speech).

12.Echopraxia (i.e., mimicking another's movements).

Residual Phase

Some symptom presentation but not as much as the active phase

Active Phase

Symptoms are present and prominent.

Prodromal Phase

Symptoms are beginning to emerge.

Schizophrenia “Type 1”

- Positive symptoms

- Delusions, hallucinations, and thought processes are more prominent

- Relatively acute onset

- Good premorbid functioning

- Exacerbations/remissions

- Normal CT scan

- Good response to antipsychotics

- Normal cognitive functioning

- Episodic

Schizophrenia “Type 2”

- Negative symptoms

- Delusions and hallucinations are less prominent

- Insidious onset

- Poor premorbid functioning

- Deteriorating course

- Ventricular enlargement

- More refracting

- Cognitive impairment

Mood-congruent schizophrenia

Congruent with grandiose or depressive delusions/symptoms

Mood incongruent schizophrenia

Congruent with passive delusions/symptoms

Circumstantiality

Adds irrelevant details to the question but reaches the goal, indirect/delayed because of excessive details, thinking becomes side-tracked

Tangentiality

Misses the goal of the question, loose and tight associations, oblique or irrelevant way of answering the question

Flight of Ideas

Rapid and pressured speech, loose association, continuous flow of accelerated speech from one topic to another, new thought triggered from a previous sentence

Perseveration

Repetition of the same response to different stimuli and/or fixation.

Verbigeration or Palilalia

Meaningless or stereotype repetition of words and phrases; words and phrases are repeated at the end of the sentence.

Clang Association

The sound of words is associated to another word. A syllable in the word comes sometimes cause clang association.

Blocking

Associated with emotionally laden material; sometimes, the person loses their train thought.

Derailment

Going off track when conversing but can get back on track

Word salad

Unintelligible gibberish and very severe.