See also: Antipsychotics
All psych: Psych Interview Reference
Core Clinical Features of Psychosis
| Symptom | Description | Notes |
|---|---|---|
| Delusions | Fixed beliefs not amenable to change in light of conflicting evidence | Persecutory, grandiose, somatic, etc. |
| Hallucinations | Perception-like experiences without external stimuli (auditory, visual, tactile, gustatory, olfactory). | Often auditory in schizophrenia. |
| Disorganized Speech | Incoherent “word salad,” tangential or circumstantial speech, thought blocking. | Jumping between topics or abruptly stopping mid thought. |
| Disorganized/Catatonic Behavior | Unpredictable agitation, lack of response, rigid posturing, purposeless movements. | May involve mutism, stupor, or purposeless motor activity. |
| Negative Symptoms | Diminished emotional expression, avolition, anhedonia, alogia, asociality. | Often appear as flat affect, reduced motivation, social withdrawal. |
Types and Duration
| Disorder | Duration |
|---|---|
| Delusional Disorder | Delusions ≥ 1 month |
| Brief Psychotic Disorder | 1 day– 1 month |
| Schizophreniform | 1– 6 months |
| Schizophrenia | ≥ 6 months |
| Schizoaffective Disorder | Chronic; also has mood component |
Clinical Presentation of Specific Disorders
Delusional Disorder:
- One or more delusions for at least one month (e.g. persecutory, jealous, grandiose).
Brief Psychotic Disorder: - Delusions, hallucinations, disorganized speech, or catatonic behavior for at least 1 day but less than 1 month.
Schizophreniform Disorder: - Same core symptoms as schizophrenia (delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms), lasting 1–6 months.
Schizophrenia: - Same core symptoms, lasting at least 6 months, with 1 month of active-phase symptoms.
Schizoaffective Disorder: - Major mood episode + psychotic symptoms; at least 2 weeks of psychotic symptoms in the absence of a major mood episode