General Description
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC
The Psychotic Disorders in the DSM-IV are Schizophrenia, Schizophrenifrom Disorder (295.40) , Schizoaffective Disorder (295.70), Delusional Disorder (297.1), Brief Psychotic Disorder (298.8), Shared Psychotic Disorder (297.3), Psychotic Disorder Due to a General Medical Condition (with delusions 293.81) (with hallucinations 293.82), Substance Induced Psychotic Disorder, and Psychotic Disorder Not Otherwise Specified (298.9) .
Schizophrenia has 5 different subtypes they are Paranoid Type (295.30), Disorganized Type (295.10), Catatonic Type (295.20), Undifferentiated Type (295.90), and Residual Type (295.60).
Psychotic Disorders are fairly hard to group and summarize because the definition of Psychotic has been disagreed upon throughout history. Also some psychotic disorders could also fit into other disorder categories. However the main way psychotic is define as of now is an individual that has delusions or hallucinations that they may or may not know are fake. Psychotic could also mean disorganized speech, or disorganized or catatonic behavior.
One thing that often looks like a Psychotic Disorder but is not is Delirium. Delirium may be considered a subcategory of psychosis. The presence of Delirium could indicate etiologic physical disease or substance use.
Diagnostic Criteria
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC
An individual could be diagnosed with Schizophrenia if the following symptoms are seen.
- At least two of the following, occur a significant amount of time in a 1-month period:
- Delusions
- Hallucinations
- Disorganized speech
- Overly unorganized or catatonic behavior
- Negative symptoms such as affective behavior, alogia, or avolition
The symptoms in 1 are necessary if the individual's delusion and hallucination are very strange or if the individual hears voices about their behavior or thoughts, or if at least two voices are talking to each other.
- Social/Occupational Dysfunction: The symptoms affect the individuals work, relationships, self-care, or other important aspects of their life. For children or an adolescent they may not achieve what is expected in an academic, interpersonal, or occupational level.
- Duration: The disturbance lasts for at least 6 months, with at least the symptoms describe in part 1 occurring for a month (or under a successful treatment for symptoms) and must include prodomal or residual periods.
- Schizoaffective and Mood Disorder exclusion: Schizoaffective and Mood Disorder can not justify the symptoms that are occurring.
- Substance/general medical condition exclusion: The symptoms can not be justified by the use of a substance or a general medical condition.
- Relationship to a Pervasive Developmental Disorder: If individual has a history of Autistic Disorder or a PDD then Schizophrenia is only diagnosis if delusions and hallucinations are also occurred for at least one month or have been successfully treated.
A person could be diagnosed with the Paranoid Type (295.30) of Schizophrenia if the following symptoms are seen.
- Overly occupied with at least one delusion or frequent auditory hallucination.
- The individual does not noticeably have disorganized speech, disorganized or catatonic behavior, or flat inappropriate affect.
A person could be diagnosed with the Disorganized Type (295.10) of Schizophrenia if the following symptoms are seen.
- All of the following are exhibited:
- Disorganized speech
- Disorganized behavior
- Flat or inappropriate affect
- The criteria for Catatonic Behavior are not met.
A person could be diagnosed with the Catatonic Type (295.20) of Schizophrenia if the following symptoms are seen.
- Two or more of the following are seen more than any other symptoms of Schizophrenia:
- No motor movement as seen by catalepsy or stupor.
- Overly active motor movement that seems to have no meaning and does not occur due to external stimuli.
- Tremendous lack of co-operation to all instructions such as a rigid posture when attempting to move, or no speech.
- Strange voluntary movements or inappropriate or bizarre postures.
- Echolalia or echopraxia
A person could be diagnosed with the Undifferentiated Type (295.90) of Schizophrenia if the following symptoms are seen.
- When the symptoms mentioned in part 1 of the diagnosis's of Schizophrenia are met but the individual does not meet the symptoms for the Paranoid, Disorganized, or Catatonic types.
A person could be diagnosed with the Residual Type (295.60) of Schizophrenia if the following symptoms are seen.
- Lack of noticeable delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.
- There is still evidence of the disorder, as seen in negative symptoms, or at least two the symptoms listed in part 1 for the diagnosis of Schizophrenia.
Schizoaffective Disorder (295.70)
An individual could be diagnosis with Schizoaffective Disorder (295.70) if the following symptoms are seen.
- The illness is uninterrupted and during it a Major Depressive Episode, Manic Episode, or Mixed Episode occurs along with the symptoms mentioned in part 1 of the diagnostic for Schizophrenia.
- During the same illness period there has been delusions and hallucinations for 2 or more weeks in which mood symptoms did not occur.
- During the illness, whether it is active or residual, mood symptoms occur for most of that time.
- These symptoms can not be justified by the use of a substance, or a general medical condition.
Etiology
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC.
Psychotic Disorder tends to be genetic. For example, Schizophrenia is ten times more likely to occur in individual that have first-degree biological relatives with Schizophrenia.
Comorbidity
Some common disorders associated with individuals that have Schizophrenia are depression, mood disorders, conduct disorder and Oppositional Defiant Disorder. Substance abuse is also more common and affects about 30 to 50% of children with schizophrenia. OCD has also been seen in people with Schizophrenia.
Prevalence
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC.
About 1% of the world's population has psychotic disorders. Symptoms for most psychotic disorders often first appear when an individual is in their late teens to 30's. Psychotic disorders affect men and women equally. Men more commonly develop symptoms of schizophrenia between 18 to 25 years old, while women tend to develop symptoms of schizophrenia between 25 years old to the mid 30's. Late onset (after 40 years old) is more common in women then in men.
EBP Treatment Approaches
Listed below are either evidence-based practices or promising practices that have been successful at treating Schizophrenia.
Psychosocial Treatments
- Psychoeducational Therapy for the child and for the family
- Family Intervention Programs
Pharmacological Treatments
(Click on Medications)
References
Volkmar, F. R. (1996). Childhood and adolescent psychosis: a review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry;35:843-851.
Note - Full text is available through the University at Buffalo Libraries.
Links
Schizophrenia Home Page (www.schizophrenia.com)
National Schizophrenia Fellowship (U.K.)
Schizophrenia Society of Canada
B.C. Schizophrenia Society
The Experience of Schizophrenia
Schizophrenia and Other Psychotic Disorders
Open the Doors
World Fellowship for Schizophrenia and Allied Disorders
Queensland Centre for Schizophrenia Research
Schizophrenia Society of Ontario
Yahoo's Schizophrenia Links
Sights and Sounds of Schizophrenia
Fact Sheets
Fact Sheets from the American Academy of Child and Adolescent Psychiatry
Note - Click on topic. (Please note disclaimer).
The AACAP developed Facts for Families to provide concise and up-to-date information on issues that affect children, teenagers, and their families.
The AACAP website includes facts, statistics, and overviews of different problems children and adolescents face and different mental health disorders that affect children and adolescents.
Fact Sheets from the National Institute of Mental Health
Note - Click on "select a topic".
NIMH offers a variety of publications and other educational resources to help people with mental health disorders, the general public, mental health and health care practitioners, and researchers gain a better understanding of mental illnesses and the research programs of the NIMH.
This website includes facts, statistics, pamphlets, checklists, and overviews of mental health disorders.
Fact Sheets from the National Mental Health Association
Note - Click on topic.
The NMHA offers answers to frequently asked questions, facts, statistics and overviews about different mental health disorders, as well as information about treatments and other problems that affect children and adolescents.
Top
