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The Cleveland Clinic

Psychotic Disorders

Psychotic disorders are a group of serious illnesses that affect the mind. These illnesses alter a person's ability to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality and behave appropriately. When symptoms are severe, people with psychotic disorders have difficulty staying in touch with reality and often are unable to meet the ordinary demands of daily life. However, even the most severe psychotic disorders usually are treatable.

There are different types of psychotic disorders, including:

  • Schizophrenia: People with this illness have changes in behavior and other symptoms—such as delusions and hallucinations—that last longer than six months, usually with a decline in work, school and social functioning.


  • Schizoaffective disorder: People with this illness have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder.


  • Schizophreniform disorder: People with this illness have symptoms of schizophrenia, but the symptoms last more than one month but less than six months.


  • Brief psychotic disorder: People with this illness have sudden, short periods of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick—usually less than a month.


  • Delusional disorder: People with this illness have delusions involving real-life situations that could be true, such as being followed, being conspired against or having a disease. These delusions persist for at least one month.


  • Shared psychotic disorder: This illness occurs when a person develops delusions in the context of a relationship with another person who already has his or her own delusion(s).


  • Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from some substances, such as alcohol and crack cocaine, that may cause hallucinations, delusions or confused speech.


  • Psychotic disorder due to a medical condition: Hallucinations, delusions or other symptoms may be the result of another illness that affects brain function, such as a head injury or brain tumor.


  • Paraphrenia: This is a type of schizophrenia that starts late in life and occurs in the elderly population.

What are the symptoms of a psychotic disorder?

Symptoms vary from person to person and may change over time. The major symptoms of psychotic disorders are hallucinations and delusions.

Hallucinations are unusual sensory experiences or perceptions of things that aren't actually present, such as seeing things that aren't there, hearing voices, smelling odors, having a "funny" taste in your mouth and feeling sensations on your skin even though nothing is touching your body.

Delusions are false beliefs that are persistent and organized, and that do not go away after receiving logical or accurate information. For example, a person who is certain his or her food is poisoned, even if it has been proven that the food is fine, is suffering from a delusion.

Other possible symptoms of psychotic illnesses include:

  • Disorganized or incoherent speech


  • Confused thinking


  • Strange, possibly dangerous behavior


  • Slowed or unusual movements


  • Loss of interest in personal hygiene


  • Loss of interest in activities


  • Problems at school or work and with relationships


  • Cold, detached manner with the inability to express emotion


  • Mood swings or other mood symptoms, such as depression or mania

What causes psychotic disorders?

The exact cause of psychotic disorders is not known, but researchers believe that many factors may play a role. Some psychotic disorders tend to run in families, suggesting that the tendency, or likelihood, to develop the disorder may be inherited. Environmental factors may also play a role in their development, including stress, drug abuse and major life changes.

In addition, people with certain psychotic disorders may have an imbalance of certain chemicals in the brain. They may be either very sensitive to or produce too much of a chemical called dopamine. Dopamine is a neurotransmitter, a substance that helps nerve cells in the brain send messages to each other. An imbalance of dopamine affects the way the brain reacts to certain stimuli, such as sounds, smells and sights and can lead to hallucinations and delusions.



Next: How common are psychotic disorders? »

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Psychotic Disorders

Introduction

Schizoaffective disorder is a serious mental illness that has features of two different conditions, schizophrenia and an affective (mood) disorder, either major depression or bipolar disorder.

Schizophrenia is a brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality and relates to others. Depression is an illness that is marked by feelings of sadness, worthlessness or hopelessness, as well as problems concentrating and remembering details. Bipolar disorder is characterized by cycling mood changes, including severe highs (mania) and lows (depression).

Schizoaffective disorder is a life-long illness that can impact all areas of daily living, including work or school, social contacts and relationships. Most people with this illness have periodic episodes, called relapses, when their symptoms surface. While there is no cure for schizoaffective disorder, symptoms of...

Read the Schizoaffective Disorder article »











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