4.2 Other Psychotic Disorders

Question 1

DSM-5

Answer 1

• Spectrum of psychotic disorders that range from least to most severe

Question 2

Delusional Disorders

Answer 2

• Presence of delusions for at least 1 month
• No hallucinations
• Behavior is not bizarre

Question 3

Other Disorders

Answer 3

Erotomaniac Delusions - Believes people of higher status is in love with them. Usually famous people

Grandiose Delusions - Irrational ideas of their own worth, talent, knowledge, or power. They may believe they have a special relationship with famous people or even assume the identity of a famous person. Delusions are of religious nature and may lead to assumption of identity as a deity or religious leader.

Question 4

Other Disorders

Answer 4

Somatic Type - Individuals believe they have some type of general medical condition

Persecutory Type - Most common type people believe they are being persecuted or malevolently treated. Examples include being plotted against, cheated, followed, spied on, poisoned, or drugged. They may continue to speak about legal authorities or lack of satisfaction which results in violence towards the object of delusions

Mixed Type - Mixed disorders (delusions prominent but no single theme is predominant)

Jealous Type - Centers around idea that sexual partner is unfaithful. Idea is irrational and without cause. Individual has delusions and searches for evidence to justify disbelief.

Question 5

Brief Psychotic Disorders

Answer 5

• Sudden onset of psychotic symptoms that may or may not be preceded by severe psychosocial stressor.
• Symptoms last between 1 day and 1 month with eventual returning of function

Manifestations
- Incoherent speech
- Delusions/Hallucinations
- Bizarre behavior
- Disorientation

May also experience catatonic features

Question 6

Substance/Medication Induced Psychotic Disorder

Answer 6

• Hallucinations/Delusions are prominent due to intoxication, withdrawal or after-exposure to medication/toxins
• Diagnosis is made when symptoms are more severe than typical

Medications
- Alcohol
- Cocaine
- Cannabis
- Inhalants
- Opioids
- Anticholinergics
- Anticonvulsants
- Cardiovascular Medications
- Corticosteroids

Question 7

Psychotic Disorders Caused by Other Medical Conditions

Answer 7

• CNS Infections/trauma
• Hypo/Hyperthyroidism
• Renal/Hepatic Disease
• Brain abscess
• Cushing’s Syndrome (high cortisol levels)
• Neoplasms
• Temporal Lobe Epilepsy
• Wilson’s Disease

Diagnosis should not be confused with delirium

Question 8

Catatonic Disorder

Answer 8

• Physiological Consequence of General Medical Condition

Illness
- Metabolic Disorders (hepatic encephalopathy, hypo/hyperthyroidism, hypo/hypoadrenalism, vitamin B12 deficiency)
- Neurological Conditions (Epilepsy, tumors, cerebrovascular disease, head trauma, encephalitis)

Question 9

Schizophreniform Disorder

Answer 9

• Identical to schizophrenia but duration only lasts 1-6 months
• Identified when schizophrenia symptoms last less than 6 months, then changed to schizophrenia after 6 months.

Question 10

Schizoaffective Disorder

Answer 10

• Symptoms of schizophrenia with strong mood disorders (depression/mania)
• Client may be depressed, psychomotor retardation, suicidal, euphoria, grandiosity, and hyperactivity.
• Mood disorders must be prominent for the majority of time