Question

Psychotic disorders and schizophrenic disorders are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some clients; whereas, within other clients, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms such as neurocognitive impairments, social problems, and illusions may exist in schizophrenic clients, but are also contributing symptoms for other psychotic disorders.

For this Discussion, consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.

With these thoughts in mind:

Post a brief explanation of whether psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Then explain why or why not. Finally, explain possible alternative diagnoses for psychosis-related symptoms.

Answer 1

Psychotic symptoms can be of varied presentations , usually symptoms or disorder of thought and perception are suggestive of patient having psychosis. Eg. Disoder of content of thought ie. Delusion , disorder of form of thought loosening of association , disorder of perception illusion or hallucinations etc.

Psychosis or related symptoms are suggestive of schizophrenia but , not always does it suggests schizophrenia.

For a person to be diagnosed schizophrenia according to DSM 5 person should have any two or more of the following 1.Delusion 2.Hallucination 3. Disorganized speech .4 disorganized behavior 5. Negative symptoms ie diminished emotional expression .or avolition

Above symptoms should be present at least for one or more months, should cause impairement in social ,personal and occupational areas of functioning.

Similar above mentioned symptoms if not present for one or more months patient is diagnosed schizophreniform disorder.

Also if patients have delusion or hallucinations for more than one month but that is not affecting his occupational and social functioning ,it is diagnosed as persistent delusional disorder, and not schizophrenia

Psychotic symptoms can be a part of affective disorders as well.

Eg In bipolar affective disorder even if it is disorder of mood ,patient may have delusions of various types like delusion of grandiosity in Mania, delusion of persection in Mania, nihilistic delusions in severe depression, delusion of reference in severe depression. There the diagnosis will be either Mania with psychotic symptoms or depression with psychotic symptoms.

Here I would also like to explain mood congruent and mood non congruent psychotic symptoms , symptoms that arise secondary to one's modd states and match their mood state are mood congruent which are usually suggestive of psychotic symptoms in affective or mood disorders and not schizophrenia.

Thus as mentioned and explained above differential or alternative diagnosis for psychotic symptoms can be

1.Brief psychotic disorder in which psychotic symptoms last for more than one day but less than a month.

2.schizophreniform disorder in which psychotic symptoms are like that of schizophrenia,but last for less than one month

3.persistant delusional disorder in which there is no impairement in social or occupational functioning

4. Bipolar affective disorder with psychotic symptoms

5. Major depressive disorder with psychotic symptoms

6. Substance induced psychotic symptoms

7. Psychosis due to organic or general medical conditions.