Psychotic Disorders - Symptoms

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What are psychotic disorder symptoms and signs?

Usually with any psychotic disorder, the person's inner world and behavior notably change.

Behavior changes might include the following:

  • Social withdrawal
  • Agitation or anxiety
  • Depersonalization (intense anxiety and a feeling of being unreal)
  • Loss of appetite
  • Worsened hygiene
  • Disorganized speech and behaviors
  • Catatonic behavior, in which the affected person's body may be rigid and the person may be unresponsive

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 appearance of being ill. In other cases, the illness may be more apparent, causing bizarre behaviors. For example, a person suffering from psychosis may wear aluminum foil in the belief that it will stop one's thoughts from being broadcasted and protect against malicious waves entering the brain.

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 or otherwise hallucinating, suspiciousness, feeling under constant surveillance, delusions, or making up words without a meaning (neologisms)
  • Negative (or deficit) symptoms: social withdrawal, difficulty in expressing emotions (in extreme cases called blunted affect), difficulty in taking care of themselves, inability to feel pleasure (These symptoms cause severe impairment.)
  • Cognitive symptoms: difficulties attending to and processing of information, in understanding the environment, and in remembering simple tasks
  • Affective (or mood) symptoms: often manifested by depression, accounting for a very high rate of attempted suicide in people suffering from schizophrenia and other 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 mental confusion and indecision to intrusive and bizarre thoughts. Also, symptoms can arise and disappear suddenly, with the mother appearing lucid one moment and psychotic the next.

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Comment from: Miguel, 35-44 Male (Patient) Published: July 18

Some 20 years ago, I was diagnosed with depression, and no medicines seemed to work, until I found agomelatine (Valdoxan) a couple of years ago. About eight years ago, my psychiatric diagnosed me with paranoia, and I started to be medicated with amisulpride (Socian). My suspicious behavior toward my girlfriend ceased, but I could never cope with thoughts of others gossiping and joking about me. That situation led to my suicide attempt a year ago. Now I have a prescription of quetiapine (200 mg), but even so, there are some events that trigger an episode, leaving me feeling desperate, restless, and sleepless. Those episodes are triggered when I am in a social event, among people who know me.

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