Other Psychotic Disorders By : Dr Seddigh HUMS

Other Psychotic Disorders Schizophreniform Disorder Brief Psychotic Disorder Schizoaffective Disorder Delusional Disorder Shared Psychotic Disorder

What is a Psychotic Disorder Psychosis A break from reality Often involves difficulties interacting with and perceiving the real world Split between thoughts and emotions

Schizophrenia - DSM Diagnostic Criterion “A” Characteristic Sxs (2 + for 1 month) delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative Sxs (flat affect, alogia, avolition) (Only one element required if delusions bizarre, or hallucinations commentary 2 voices conversing )

Schizophrenia - DSM Diagnostic Criteria B - F B: Social/occupational dysfunction (decline) C: Duration - 6 months total, 1 month “A” Sxs D: Exclusion - SAFD, mood d/o E :Exclusion - sub abuse, gen med condition F: PDD/Autism - at least 1 month delusions or hallucinations

Schizophreniform Disorder

Schizophreniform Disorder Criteria A, D, and E of Schizophrenia are met (To help you remember: Criteria A: 2+ characteristic symptoms (delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative affect) present for significant part of month Criteria D: Schizoaffective Disorder and Mood Disorder with Psychotic Features have been ruled out Criteria E: Not due to a GMC or substance) An episode of the disorder (including the prodromal, active, and residual phases) lasts at least 1 month but less than 6 months

Schizophreniform Disorder Essentially, exactly like Schizophrenia, but the duration is shorter Schizophrenia: 6 months or longer Schizophreniform: 1-6 months Often used as a provisional diagnosis during the first months of a psychotic illness Thus, this diagnosis not infrequently changes to Schizophrenia after 6 months have passed without complete recovery

Facts about Schizophreniform Disorder Prevalence: Varies substantially: Approx. 0.2% in industrialized areas Approx. 1% in non-industrialized areas May be explained by higher functioning and better prognosis for psychotic disorders in non-industrialized areas Gender: Approx. equal rates Age of Onset: Same as Schizophrenia (keep in mind gender differences) Course: 1/3 recover within the 6 month period 2/3 progress into Schizophrenia

Brief Psychotic Disorder

Brief Psychotic Disorder A. Presence of one or more of the following symptoms: Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid levels of functioning C. Disturbance is not better accounted for by another mental disorder and is not due to a GMC or substance

Brief Psychotic Disorder vs. Schizophrenia/Schizophreniform Criteria Schizophrenia/Schizophreniform Disorder 2 symptoms needed (there is an exception to this rule) Can include Negative Affect Brief Psychotic Disorder Only 1 symptom needed Cannot be Negative affect Duration Schizophrenia: 6+ months Schizophreniform Disorder: 1 – 6 months Brief Psychotic Disorder: 1 day – 1 month

Facts about Brief Psychotic Disorder Prevalence: Unknown (symptoms often do not persist long enough to come to the attention of mental health professionals or researchers) Gender: Unknown, can assume to be equal Age of Onset: Late adolescence to early adulthood Course: By definition, no longer than 1-month

Schizoaffective Disorder

Schizoaffective Disorder An uninterrupted period of illness during which, at some time, there is either a Major Depressive Episode, a Manic Episode, or a Mixed Episode concurrent with symptoms that meet Criterion A for Schizophrenia During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the illness Not due to a GMC or substance

Subtypes of Schizoaffective Disorder Bipolar Type: if the disturbance includes a Manic or a Mixed episode Depressive Type: if the disturbance only includes Major Depressive Episodes

Facts about Schizoaffective Disorder Prevalence: Unknown, but seems to be less common than Schizophrenia Gender: Equal rates of Bipolar Subtype Women tend to have higher rates of the Depressive subtype Age of Onset: Late adolescence to late in life Average age = early adulthood Bipolar Subtype – more common in younger adults Depressive Subtype – more common in older adults Course: Better prognosis than Schizophrenia, worse prognosis than mood disorders Better prognosis for Bipolar subtype

Delusional Disorder

Delusional Disorder Nonbizarre delusions lasting for at least 1 month Criterion A for Schizophrenia have never been met (However, tactile and olfactory may be present if they are related to the delusional theme) Behavioral functioning is not markedly imparied and behavior is not obviously odd or bizarre If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods Not due to the direct effects of a GMC or substance

Types of Delusional Disorder Erotomanic – delusions that another person, usually of higher status, is in love with the individual Grandiose – delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person Jealous – delusions that the individual’s partner is unfaithful Persecutory – delusions that the person (or someone who is close to the person) is being malevolently treated in some way (most common) Somatic – delusions that the person has some physical defect or general medical connection Mixed – delusions characteristic of more than one of the above types but no one theme predominates Unspecified – no information provided

Facts about Delusional Disorder Prevalence: 0.03% (community samples) 1-2% of inpatient mental health admissions Gender: Equal rates, however, rates of specific types of delusional disorder may vary (e.g. Jealous type) Age of Onset: Can be quite variable – ranging from adolescence to late in life Course: Can also be quite variable Can be chronic or may remit completely Symptoms may wax and wane or disappear completely and then reappear

Shared Psychotic Disorder (Folie á Deux)

Shared Psychotic Disorder (Folie á Deux) A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion The delusion is similar in content to that of the person who already has the established delusion The disturbance is not better accounted for by another psychotic disorder or is due to a GMC or substance

Shared Psychotic Disorder The delusions are shared between two people are in a close relationship (husband and wife, parent and child, siblings, etc.) Typically, the person with the original delusion is the more dominant personality in the relationship Generally the delusions are only shared by two people, but can be shared among large groups of people as well

Facts about Shared Psychotic Disorder Prevalence: Unknown, goes unrecognized Gender: Somewhat more common in women Age of Onset: Seems to vary Course: Tends to be chronic, because the disorder tends to afflict people in extremely close, long-lasting relationships However, if separated from the person with the original delusions, the delusions usually dissipate