Schizophrenia Spectrum and Other Psychotic Disorders

Schizophrenia spectrum

They are defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms.

Delusions

Fixed beliefs that are not amenable to change in light of conflicting evidence.

Themes of Delusions

Persecutory, referential, somatic, religious, grandiose

Persecutory delusions

Belief that one is going to be harmed, harassed, and so

forth by an individual, organization, or other group

Persecutory delusions

Belief that certain gestures, comments, environmental cues, and so forth are directed at oneself

Referential delusions

Belief that certain gestures, comments, environmental cues, and so forth are directed at oneself

Grandiose delusions

When an individual believes that he or she has exceptional abilities, wealth, or fame

Erotomanic delusions

When an individual believes falsely that another person is in love with him or her

Nihilistic delusions

Involve the conviction that a major catastrophe will occur

Somatic delusions

Focus on preoccupations regarding health and organ function

Bizarre delusions

Clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences

Nonbizarre delusions

The belief that one is under surveillance by the police

Hallucinations

Perception-like experiences that occur without an external stimulus

The most common in schizophrenia

Auditory hallucinations

Disorganized thinking (formal thought disorder)

Derailment or loose associations, tangentiality, incoherence or “word salad”, glossolalia (“speaking in tongues”)

Catatonic behavior

A marked decrease in reactivity to the environment.

Catatonic excitement

Purposeless and excessive motor activity without obvious cause

Negative symptoms

Two negative symptoms are particularly prominent in schizophrenia: diminished emotional expression and avolition.

Avolition

decrease in motivated self-

initiated purposeful activities.

Alogia

diminished speech output

Anhedonia

Decreased ability to experience pleasure.

Asociality

apparent lack of interest in social

interactions

Delusional Disorder

The presence of one (or more) delusions with a duration of 1 month or longer.

The following course specifiers are only to be used after a 1-year duration of the

disorder:

• First episode, currently in acute episode:

• First episode, currently in partial remission:

• First episode, currently in full remission:

• Multiple episodes, currently in acute episode

  Multiple episodes, currently in partial remission

  Multiple episodes, currently in full remission

• Continuous

Schizophreniform Disorder

An episode of the disorder lasts at least 1 month but less than 6 months.

The diagnosis of schizophreniform disorder is made under two conditions: 1) when an episode of illness lasts between 1 and 6 months and the individual has already recovered, and 2) when an individual is symptomatic for Less than the 6 months’ duration required for the diagnosis of schizophrenia but has not yet recovered. In this case, the diagnosis should be noted as “schizophreniform disorder (provisional)” because it is uncertain if the individual will recover from the disturbance within the 6-month period.

Schizophrenia

• Atleast one of tthe Criteria A

• Persist for at least 6 months

Schizoaffective Disorder

An uninterrupted period of illness during which there is a major mood episode

(major depressive or manic) concurrent with Criterion A of schizophrenia.

Substance/Medication-Induced Psychotic Disorder

Prominent delusions and/or hallucinations (Criterion A) that are judged to be due to the physiological effects of a substance/medication

Catatonia

The presence of 3 or more of 12 psychomotor features in the diagnostic criteria for catatonia associated with another mental disorder and catatonic disorder due to another medical condition.