Psychotic Disorders

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Schizophrenia Slideshow Pictures

What are psychotic disorder symptoms and signs?

The definition of psychosis is a mental disorder that includes symptoms like delusions or hallucinations that show impaired contact with and perception of reality. Usually with any psychotic disorder, the person's thoughts and behavior notably change.

Behavior changes that might occur during a psychotic break include the following:

  • Social withdrawal/social isolation or loneliness
  • Apathy
  • Agitation, restlessness, hyperactivity, or excessive excitement
  • Anxiety, nervousness, fear, or hypervigilance
  • Hostility, anger, aggression
  • Depersonalization (a combination of intense anxiety and a feeling of being unreal, detached from oneself, or that one's thoughts are not one's own)
  • Loss of appetite
  • Worsened hygiene
  • Disorganized speech like rapid and frenzied speaking, incoherent speech, and excessive wordiness
  • Disorganized behaviors, like a lack of discretion or restraint
  • Catatonic behavior, in which the affected person's body may be rigid and the person may exhibit persistent repetition of words, a deficiency of speech, or be physically and/or verbally unresponsive. The catatonic individual might also engage in repetitive movements, slowness in activity, and thought or nonsense word repetition.

Changes/problems with thinking that may occur in a psychotic disorder include

  • delusions (beliefs with no basis in reality),
  • hallucinations (for example, hearing, seeing, or perceiving things not actually present),
  • the sense of being controlled by outside forces,
  • disorganized thoughts.

A person with a psychotic disorder may not have any outward characteristics of being ill. In other cases, the illness may be more apparent, causing bizarre behaviors. For example, a person suffering from psychosis may stop bathing in the belief that it will protect against malicious individuals from attacking them.

People with psychosis vary widely in their behavior as they struggle with an illness beyond their control. Some may ramble in illogical sentences or react with uncontrolled anger or violence to a perceived threat. Characteristics of a psychotic disorder may also include phases in which the affected individuals seem to lack personality, movement, and emotion (also called a flat affect). People with a psychotic disorder may alternate between these extremes. Their behavior may or may not be predictable.

In order to better understand psychotic disorders, the concept of clusters of symptoms is often used. Thus, people with psychosis can experience symptoms that may be grouped under the following categories:

  • Positive symptoms: hearing voices that are not actually present (auditory hallucinations) or other hallucinations (seeing things: visual hallucinations; feeling things: tactile hallucinations; smelling things: olfactory hallucinations, or tasting things: gustatory hallucinations); suspiciousness to the point of paranoia, feeling that one is under frequent or constant surveillance or pursuit (persecutory delusions), religious delusions like feeling one is a deity or other false belief of superiority; or making up words without a meaning (neologisms)
  • Negative (or deficit) symptoms: social isolation, limited range of emotions, difficulty in expressing emotions (in extreme cases called blunted affect), difficulty in taking care of themselves, inability to feel pleasure, general discontent (These symptoms cause severe impairment.)
  • Cognitive symptoms: difficulties thinking and understanding information, remembering simple tasks, attending to and processing information, and understanding their environment confusion
  • Affective (or mood) symptoms: often manifested by depression, accounting for a very high rate of having thoughts and attempts at suicide in people suffering from schizophrenia and other types of psychotic disorders

Postpartum psychosis usually develops within the first three months after childbirth, often within three to 14 days. Symptoms may include auditory or visual hallucinations, delusions, or rapid mood swings. The hallucinations may have themes of violence toward herself or her baby. This condition may be associated with significant problems in thinking, ranging from disorientation and other symptoms of mental confusion and indecision to intrusive and bizarre thoughts. Also, symptoms can arise and disappear suddenly, with the mother appearing lucid one moment and exhibiting psychotic behavior the next.

Medically Reviewed by a Doctor on 2/19/2016

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