Schizophrenia Spectrum and Other Psychotic Disorders

Learn more about the symptoms of Schizophrenia, Schizoaffective Disorder, Delusional Disorder, Schizophreniform Disorder, Brief Psychotic Disorder and Catatonia. The most common treatment for these disorders is antipsychotics.


Schizophrenia

  • Criteria A: At least two of the following symptoms are present during a one month period and one of these symptoms must be (1), (2), or (3):
    • 1.Delusions (a strong belief that is not true or consistent with reality).
    • 2.Hallucinations (a sensory experience, such a hearing, seeing or feeling something, that is not actually present in reality).
    • 3. Disorganized speech (such as making up new words, lack of connection between thoughts, rapidly changing from topic to topic).
    • 4. Grossly disorganized behavior (such as changes in behavior that make it difficult for a person to take care of themselves, work or interact with others) or catatonic behavior (see symptoms of Catatonia).
    •  5. Negative symptoms (such as expressing less emotions, lack of motivation or lack of interest in activities).
  • Signs of the disturbance last for at least six months of which at least one month will have symptoms of the above criteria.
  • Decreased level of functioning in important areas of life, such as work, school, interpersonal relationships, and in ability to take care of oneself.
  • These symptoms cannot be attributed to any other substance, medication, or other medical or mental condition.

Schizoaffective Disorder

  • A period of illness during which there is a major mood episode (major depression or mania) in addition to the following Criterion A of schizophrenia. At least two of the following symptoms are present during a one month period and one of these symptoms must be (1), (2), or (3):
    •  1.Delusions (a strong belief that is not true or consistent with reality).
    • 2.Hallucinations (a sensory experience, such a hearing, seeing or feeling something, that is not actually present in reality).
    • 3. Disorganized speech (such as making up new words, lack of connection between thoughts, rapidly changing from topic to topic).
    • 4. Grossly disorganized behavior (such as changes in behavior that make it difficult for a person to take care of themselves, work or interact with others) or catatonic behavior (see symptoms of Catatonia).
    • 5. Negative symptoms (such as expressing less emotions, lack of motivation or lack of interest in activities).
  • Delusions or hallucinations for two or more weeks without the presence of a major mood episode (depression or mania).
  • Symptoms of a major mood episode (depression or mania) are present for the majority of the active portions of the illness.
  • These symptoms cannot be attributed to any other substance, medication, or other medical or mental condition.

Delusional Disorder

  • Presence of one or more delusions (a strong belief that is not true or consistent with reality) for one month or longer.
  • Criterion A for schizophrenia has never been met. If hallucinations (a sensory experience, such a hearing, seeing or feeling something, that is not actually present in reality) are present, they are not prominent and are related to the delusional theme.
  • Apart from the impact of the delusions, daily functioning is not significantly impaired and behavior is not odd.
  • If depressive or manic episodes have occurred, these periods are brief relative to the duration of the delusional periods.
  • These symptoms cannot be attributed to any other substance, medication, or other medical or mental condition.

Delusional disorder subtypes:

  • Erotomanic type: The delusion is that another person is in love with the individual.
  • Grandiose type: The individual believes they have some great talent, insight or they have made an important discovery.
  • Jealous type: The individual believes that his or her significant other is unfaithful.
  • Persecutory type: The individual believes that he or she is being conspired against, cheated on, spied on, followed, poisoned, drugged, or harassed.
  • Somatic type: The delusion involves the belief that certain bodily functions or sensations are occurring when there is no medical evidence to support these sensations.
  • Unspecified type: The dominant delusional belief cannot be clearly determined or is not described in the above specific types.

Brief Psychotic Disorder

  • Presence of one or more of the following symptoms and one of these symptoms must be (1), (2), or (3): 
    • 1.Delusions (a strong belief that is not true or consistent with reality).
    • 2.Hallucinations (a sensory experience, such a hearing, seeing or feeling something, that is not actually present in reality).
    • 3. Disorganized speech (such as making up new words, lack of connection between thoughts, rapidly changing from topic to topic).
    • 4. Grossly disorganized behavior (such as changes in behavior that make it difficult for a person to take care of themselves, work or interact with others) or catatonic behavior (see symptoms of Catatonia).
  • Symptoms last from one day to one month, with eventual return to full functioning.
  • These symptoms cannot be attributed to any other substance, medication, or other medical or mental condition.

Schizophreniform Disorder 

  • At least two of the following symptoms are present during a one month period and one of these symptoms must be (1), (2), or (3): 
    • 1.Delusions (a strong belief that is not true or consistent with reality).
    • 2.Hallucinations (a sensory experience, such a hearing, seeing or feeling something, that is not actually present in reality).
    • 3. Disorganized speech (such as making up new words, lack of connection between thoughts, rapidly changing from topic to topic).
    • 4. Grossly disorganized behavior (such as changes in behavior that make it difficult for a person to take care of themselves, work or interact with others) or catatonic behavior (see symptoms of Catatonia).
    • 5. Negative symptoms (such as expressing less emotions, lack of motivation or lack of interest in activities).
  • An episode of the disorder lasts at least one month, but less than six months.
  • These symptoms cannot be attributed to any other substance, medication, or other medical or mental condition.

Catatonia Associated with Another Mental Disorder

The presence of three or more of the following symptoms:

  • Stupor (lack of physical moment).
  • Catalepsy (loss of voluntary motion in which the limbs remain in whatever position they are placed).
  • Waxy flexibility (a decreased response to stimuli and a tendency to remain in an immobile posture). 
  • Mutism (very little or no verbal response).
  • Negativism (lack of response to instruction or external stimulus).
  • Posturing (spontaneous holding of a posture against gravity).
  • Mannerism (odd, circumstantial caricature of normal actions).
  • Stereotypy (repetitive, abnormal movements).
  • Agitation.
  • Grimacing (contorted facial expression).
  • Echolalia (imitating another’s speech).
  • Echopraxia (imitating another’s movements).
 

The above criteria are adapted from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).