Apr 3rd 2023
Psychotic disorders are a group of mental health conditions in which symptoms of psychosis occur, such as hallucinations and delusions. Treatment for psychotic disorders often includes medication and therapy.
There are various types of psychotic disorders, which involve symptoms of varying severity and length of time, although many psychotic disorders share symptomatic similarities. These symptoms and diagnostic criteria are outlined in The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), within the chapter titled Schizophrenia Spectrum and Other Psychotic Disorders .
Schizophrenia is a serious and potentially chronic condition that can require lifelong treatment. Often, a person with schizophrenia lacks insight, meaning that they are not aware of their illness, which can cause difficulties in treating and managing the condition .
Schizoaffective disorder also includes the prevalence of psychotic symptoms, particularly hallucinations or delusions, but also involves symptoms of a mood disorder, such as an episode of mania, depression, or both. For this diagnosis, there must be at least two weeks of psychotic symptoms without the presence of mania or depression .
Symptoms of a manic episode can include :
Symptoms of a depressive episode can include:
Someone with schizophreniform disorder will experience the same symptoms as those present in schizophrenia, such as hallucinations, delusions, and disorganized thinking and speech. However, unlike schizophrenia, these symptoms are only present for between one and six months .
A diagnosis of schizophreniform disorder may require altering to a diagnosis of schizophrenia if the symptoms persist beyond 6 months .
Symptoms of brief psychotic disorder include at least one symptom of psychosis, such as hallucinations or delusions, that last between one day and one month, with a return to the individual’s usual level of functioning and mental state following this episode .
Symptoms of delusional disorder include at least one month of persistent delusions, without the presence of other symptoms of psychosis and very little change in behaviors or level of functioning .
Hallucinations are not common but may occur within the theme of the experienced delusion. Similarly, changes in mood might occur within the context of the experienced delusion, such as agitation or anxiety alongside a persecutory delusion .
Symptoms of medicine or substance-induced psychotic disorder can include any signs of psychosis, such as hallucinations, delusions, and disorganized thoughts and speech, along with a lack of insight, so symptoms may appear to present as schizophrenia. However, the symptoms occur during or shortly after intoxication or withdrawal from a medication or illicit substance .
Schizotypal personality disorder differs significantly from other psychotic disorders and from other personality disorders, with symptoms that belong to both groups of disorders, thus often making it a challenge to identify .
Catatonia was previously considered a symptom of schizophrenia but has since been reclassified as a mental health disorder on its own, as it can occur with or without the presence of schizophrenia or within the context of other conditions .
However, a large proportion of people with schizophrenia or another psychotic disorder do not have a relative with a similar condition, indicating the prevalence of other contributing risk factors .
Studies have shown that people with a psychotic disorder often have a reduced volume of gray matter in their brain, along with higher levels of dopamine activity, thus suggesting a neurological impact in the development of these conditions .
Several environmental factors are believed to increase the risk of developing a psychotic disorder, including living in an urban area, being of a low socio-economic status, being an ethnic minority, or being an immigrant .
Various studies indicate that several factors relating to pregnancy and childbirth can increase the risk of a psychotic disorder, including prenatal malnutrition and drug exposure, premature birth, being born by caesarian section, and being born in winter .
To make a diagnosis of a psychotic disorder, a doctor will first gather a full mental and physical health history of the individual and their family, ascertaining information about any prior diagnoses in the family.
They will likely conduct a thorough physical health examination to determine if there is a presence of any medical conditions or impaired brain functioning that could cause symptoms of a psychotic disorder, which may include an MRI or CT scan .
They will conduct a mental state examination, to gather information about the individual’s thoughts, behaviors, emotions, speech, and sleep, and enquire about the symptoms that the individual has been experiencing. They will ask how and to what extent these symptoms have impacted daily, social, or professional functioning .
With the information gathered from these examinations and questions, they will utilize diagnostic criteria from the DSM-5 to determine a diagnosis. As psychotic disorders often share similar symptoms, it is vital for the doctor to have a thorough understanding of the presenting symptoms, in order to rule out certain conditions and to clearly identify a specific diagnosis .
For example, diagnostic criteria often require specific information relating to :
As psychotic disorders may involve varying symptoms and impairments in functioning, treatment options for each condition may also vary. However, for all psychotic disorders, the most effective approach to treatment involves the use of both medication and therapeutic intervention .
Certain psychotic disorders may benefit from the use of other types of medications, which are often prescribed alongside an antipsychotic. This might include antidepressant medications, mood stabilizers, benzodiazepines, or stimulants .
People often respond differently to medications, so what is effective for one person may not be effective for another, and it may be required to try several medications, or a combination of medications, before finding the most effective treatment.
It is important to take medications exactly as prescribed, as missing doses, taking too much medication in one go, or suddenly stopping a medication can cause serious adverse effects and can worsen symptoms.
In some cases, it may be necessary for care to be provided in an inpatient setting, if there is a serious risk of harm to the individual or others. The purpose of this is to help stabilize and manage symptoms of the disorder with appropriate professional intervention, aiming to return the individual to the community as soon as it is safe to do so .
Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.
MentalHealth.com is a patient-first health technology company driven by its mission to make optimal mental health attainable for everyone. With a focus on expanding care access, empowering patient choice, and enhancing care quality, the company delivers innovative solutions that support individuals throughout their mental health journey.