Psychotic Disorders 1 What is Psychosis Do you

Psychotic Disorders 1

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. 2

The Psychotic Disorders § § § Schizophrenia/ Schizoaffective Disorder Delusional Disorder Shared Psychotic Disorder Bipolar Disorder with Psychotic Features Major Depressive Disorder with Psychotic Features January-February 2010 3

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. 4

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) 5

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. January-February 2010 6

Types of Schizophrenia § § Paranoid Disorganized Catatonic (Schizoaffective Disorder) 7

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. 8

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). 9

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 10

Characteristic Symptoms: Depressive Disorder § § § Sad or negative mood Helpless and hopeless presentation Unrealistically negative or cynical presentation § Lack of accurate reality testing. § Distorted views 11

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 12

§ Barricade situation involving a stalking victim § Bizarre suicide attempts, such as selfmutilation or mass suicide § Cult behavior § Disturbance calls § Public intoxication calls 13