Psychotic Disorders

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Psychotic Disorders


The term psychotic has historically received a number of different definitions, none of which has achieved universal acceptance. The narrowest definition of psychotic is restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature. A slightly less restrictive definition would also include prominent hallucinations that the individualrealizes are hallucinatory experiences. Broader still is a definition that also includes other symptoms of Schizophrenia (i.e., disorganized speech, grossly disorganized or catatonic behavior).

Delusional Disorder
Characterized by at least 1 month of nonbizarre delusions without other active-phase symptoms of Schizophrenia.
Brief Psychotic Disorder
A psychotic disturbance that lasts more than 1 day and remits by 1 month.
Shared Psychotic Disorder

A disturbance that develops in an individual who is influenced by someone else who has an established delusion with similar content.

Diagnostic Features

The essential feature of Shared Psychotic Disorder is a delusion that develops in someone who is involved in a close relationship with another person who already has a Psychotic Disorder. The individual comes to share the delusional beliefs of the other person in whole or in part. Schizophrenia is the most common diagnosis of the other person, although other diagnoses may include Delusional Disorder or Mood Disorder With Psychotic Features. The content of the shared delusional beliefs can include relatively bizarre delusions (e.g., that radiation is being transmitted into an apartment from a hostile foreign power, causing indigestion and diarrhea), mood-congruent delusions (e.g., that the primary case will soon receive a film contract for $2 million, allowing the family to purchase a much larger home with a swimming pool), or the nonbizarre delusions that are characteristic of Delusional Disorder (e.g., the FBI is tapping the family telephone and trailing family members when they go out). Usually the other person in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person. Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative social isolation. If the relationship with the primary case is stopped, the delusional beliefs of the other individual usually diminish or disappear. Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur among a larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent's delusional beliefs.

Psychotic Disorder Due to a General Medical Condition
The psychotic symptoms are judged to be a direct physiological consequence of a general medical condition.
Substance-Induced Psychotic Disorder
The psychotic symptoms are judged to be a direct physiological consequence of a drug of abuse, a medication, or toxin exposure.
Psychotic Disorder Not Otherwise Specified
Included for classifying psychotic presentations that do not meet the criteria for any of the specific Psychotic Disorders defined in this section or psychotic symptomatology about which there is inadequate or contradictory information.
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