Psychotic Disorders

What is Psychosis? “Do you hear or see things that other people don’t?” Hallucinations- distortions of sensory input (seeing things, visions, illusions, etc.) Delusions- distortions of thought (non-real thinking, lack of reality testing, odd thinking, etc.) General loss of touch with reality.

The Psychotic Disorders Schizophrenia/ Schizoaffective Disorder Delusional Disorder Shared Psychotic Disorder Bipolar Disorder with Psychotic Features Major Depressive Disorder with Psychotic Features January-February 2010

Psychotic Disorders: Key Facts Symptoms may appear either gradually or suddenly. Onset of symptoms typically occurs between the late teens and mid-30’s. May also occur after age 45 in rare instances. Males and females equally impacted. Community prevalence of these disorders is approximately .5% to 1% of the general population. Strong genetic link- with first-degree relatives having a ten times greater risk.

Diagnostic Criteria: Schizophrenia Characteristic symptoms of schizophrenia: two or more of the following symptoms delusions hallucinations disorganized speech grossly disorganized or catatonic behavior lack of appropriate emotion (flat affect)

Schizophrenia Social/occupational dysfunction in the following areas: work, interpersonal relationships, and self-care. In paranoid schizophrenia, the person is often preoccupied with the delusions and hallucinations, which may have a persecutory or grandiose content. January-February 2010

Types of Schizophrenia Paranoid Disorganized Catatonic (Schizoaffective Disorder)

Characteristic Symptoms: Delusional Disorder Delusion is not bizarre (can happen in real life). Social and occupational functioning may not be impaired, except as directly impacted by the delusions. Types: erotomanic, grandiose, jealous, persecutory, or somatic. Intended victim is thought to be “ in love” with the perpetrator. Victim often of higher status. Stalking behavior is common.

Characteristic Symptoms: Shared Psychotic Disorder Also known as “folie a deaux.” The delusion develops in the context of a relationship with another person. One person takes on the delusions of the other. Perpetrators share a common delusion, usually that of the dominant personality. The disorder is enhanced by social isolation. May dominate the lives of a family or a group (sect or cult).

Characteristic Symptoms: Bipolar Disorder Pressured speech Delusional content, if not frank delusions Restlessness, sleeplessness, and temper outbursts Overspending, drug or alcohol use, and hypersexuality Easily confused with use of amphetamines, cocaine

Characteristic Symptoms: Depressive Disorder Sad or negative mood Helpless and hopeless presentation Unrealistically negative or cynical presentation Lack of accurate reality testing. Distorted views

Law Enforcement Encounters Family disturbance, especially where perpetrator is older male child Bizarre crimes Attempted ( or successful) takeover of high-profile location (church, TV station, police substation, etc.) Encounters with the homeless

Barricade situation involving a stalking victim Bizarre suicide attempts, such as self-mutilation or mass suicide Cult behavior Disturbance calls Public intoxication calls