Psychotic Disorders

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

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.

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