Part Two of Schizophrenia Spectrum and Other Psychotic Disorders

Part Two of Schizophrenia Spectrum and Other Psychotic Disorders will cover Brief Psychotic Disorder, Psychotic Disorder Due to Another Medical Condition, and Substance/Medication-Induced Psychotic Disorder.

Click HERE to read the introduction to this blog series, Mental Health Diagnoses!, which covers how diagnosis using the Diagnostic and Statistical Manual- 5 (DSM-5) works.

 What is Psychosis?

The word ‘psychotic’ is often used in casual conversation as a derogatory slang to ‘poke’ or ‘make fun’ of someone.  Doing so is not only offensive to the individual being called psychotic, but it is also offensive to persons who are diagnosed with a psychotic disorder.  In addition, the term ‘psychotic’ is often times being used incorrectly.

Psychotic is typically defined as an individual who experiences or suffers from a psychosis.  It is appropriate to say that an individual experiences psychosis and/or an individual has been diagnosed with a psychotic disorder.

So, what is psychosis? Psychosis is the presence of one or more of the five domains:  hallucinations, delusions, disorganized speech, or grossly disorganized behavior or catatonic behavior.  Each of these characteristics were defined in detail in the Introduction to Schizophrenia Spectrum and other Psychotic Disorders blog entry. Click HERE for a refresher.

What differentiates Psychotic Disorders from the disorders of the Schizophrenia Spectrum?

You may be asking yourself, “If Psychotic Disorders are also classified by the five domains, how do they differ from the Schizophrenia Spectrum disorders within this class?”  The characteristics are similar, but they differ in duration, presence, and severity of symptoms.  When diagnosing an individual with a Psychotic Disorder, the helping professional must also assess their client’s cognition, their level of depression, and the presence and/or severity of manic symptoms in order to rule out the schizophrenia disorders (Diagnostic and Statistical Manual of Mental Disorders, 2013).

 Similarities between Substance/Medication-Induced Psychotic Disorder and Psychotic Disorder due to Another Medical Condition

Substance/Medication-Induced Psychotic Disorder and Psychotic Disorder due to Another Medical Condition are similar in four ways:

  1. They require the individual to have either delusions or hallucinations;
  2. There “is evidence from the [client’s social and medical] history, physical examination, or laboratory findings” of delusions and hallucinations;
  3. Their symptoms are not attributed to another mental disorder (like Schizophrenia) and/or the effects of another medical condition (like dementia);
  4. The disturbances cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning” (Diagnostic and Statistical Manual of Mental Disorders, 2013).

 Psychotic Disorder Due to Another Medical Condition

Diagnosis with Psychotic Disorder due to Another Medical Condition occurs when an individual has either delusions or hallucinations that are caused by a medical condition.  These disturbances must not “occur exclusively during the course of a delirium,” which is incoherence of thought and speech, illusions, and restlessness (Diagnostic and Statistical Manual of Mental Disorders, 2013).

As previously mentioned, diagnosis requires that there be evidence that connects the psychosis to a medical condition.  Examples of medical conditions that cause psychosis include, but are not limited to:  brain diseases, such as Parkinson’s or Huntington’s disease; brain tumors; brain cysts; Dementia; Alzheimer’s Disease; Stroke; and, Human Immunodeficiency Virus, or HIV.

 Substance/Medication-Induced Psychotic Disorder

In addition to the previously mentioned criteria, diagnosis with Substance/Medication-Induced Psychotic Disorder requires that delusions or hallucinations develop during or soon after an individual becomes intoxicated from a substance, withdraws from a substance, or after the individual has been exposed to a medication (Diagnostic and Statistical Manual of Mental Disorders, 2013).  It is important to note that the substance or medication that the person has ingested or been exposed to is not capable of producing delusions or hallucinations on their own.  This means that a person who takes LSD does not qualify for this diagnosis because LSD is known to cause hallucinations.

 Brief Psychotic Disorder

A person is diagnosed with Brief Psychotic Disorder when they go from a ‘normal’ “nonpsychotic state [of mind] to a clearly psychotic state [of mind] within two weeks” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  This means that the person suddenly begins to experience at least one of the five domains that characterize Schizophrenia Spectrum and Other Psychotic Disorders (see above).  These behaviors continue for at least one day but not more than one month.  If the symptoms continue after one month, meaning the individual does not return to their normal nonpsychotic state of mind, then they will qualify for another disorder within this class.  As with all disorders within the DSM-5, it is necessary to consider whether or not another mental disorder, the physiological effects of a substance, and/or the effects of another medical condition are affecting the individual.

Stay tuned for the third and final installment of Schizophrenia Spectrum and other Psychotic Disorders!

Part three will cover Catatonia Associated With Another Mental Disorder (Catatonia Specifier), Catatonic Disorder Due to Another Medical Condition, and Delusional Disorder.

References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 20 January 2018]. dsm.psychiatryonline.org

 

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