1. Psychotic Disorders

2. 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.

3. 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

4. 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.

5. 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)

6. 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

7. Types of Schizophrenia
Paranoid
Disorganized
Catatonic
(Schizoaffective Disorder)

8. 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.

9. 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).

10. 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

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

12. 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

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