Psychotic Disorders Dsm 5

Front 1

General Characteristics

Back 1

Psychotic symptoms (positive and negative) are prominent aspect of the presentation

The term "psychotic" refers to delusions, prominent hallucinations, disorganized speech, or disorganized or catatonic behavior

Mood disturbances are often present

Front 2

Positive Symptoms

Back 2

Excess or distortion of normal functions

1. hallucinations (perception) - auditory most common, then visual

2. delusions (thought content)

3. Disorganized thought / speech (thought process / language)

4. Disorganized or catatonic behavior (self-monitoring of behavior)

Front 3

Negative Symptoms

Back 3

Decrease or loss in normal functions

1. Flat affect (restricted range and intensity of emotional expression)

2. Alogia (restricted fluency and productivity of thought and speech)

3. Avolition (restricted motivation for initiation of goal-directed behavior)

4. Anhedonia (restricted ability to experience pleasure from positive experiences)

5. Asociality (restricted interest in social interactions)

Front 4

Schizophrenia

Back 4

1. (2 out of 5) mixture of positive and negative symptoms - (must have positive symptoms 1,2 or 3) that are present for a significant portion of time during a 1-month period with some signs of the disorder persisting for at least 6 months

2. Marked decline in social and occupational functioning

3. symptoms not better accounted by schizoaffective or mood disorder with psychotic features

4. symptoms not accounted by another medical condition, substance that is etiologically related to the development of symptoms

5. can be diagnosed in addition to a neurodevelopmental disorder

Front 5

Schizophrenia

Associated Features

Back 5

1. inappropriate affect

2. disturbance in sleep patterns

3. lack of interest in eating or refusal to eat

4. psychomotor agitation or retardation

5. difficulty with concentration,attention, and memory

6. poor insight into presence of symptoms

7. depersonalization, derealization, and somatic concerns that may reach delusional proportions

8. Odd ritualistic or stereotyped behaviors

9. anxiety and phobias

10. assaultive, violent, or unpredictable behavior

11. high comorbidity rates with substance related disorders, anxiety and personality disorders (schizotypal, schizoid, and paranoid)

Front 6

Schizophrenia

Course

Back 6

1. median onset age for men is early to mid-20s, women in late 20's

2. onset can be abrupt or insidious, most display some prodromal symptoms that gradually develop into active phase

3. course varies but complete remission not common. Some relatively stable course and others show progressive worsening.

4. observed worldwide

5. cultural factors need to be taken into account

6. diagnosed more often in some ethnic groups (af. am. and asian am.)

Front 7

Schizophrenia

Differential Diagnosis

Back 7

Delirium, dementia, substance-related disorders, psychotic disorders due to another medical condition like brain tumor, Alzheimer's.

Neurodevelopmental Disorders - share disturbances in language, affect, social / interpersonal deficits but are typically diagnosed in childhood. ND absence of delusions or hallucinations. Schizophrenia can superimpose ND diagnosis

Schizoaffective Disorder and Mood Disorder with Psychotic features - mood distubances do not meet full criteria for mood episode in Schizophrenia, and mood disorder can superimpose Schizophrenia if warrants separate clinical attention

Other Psychotic Disorders

Front 8

Schizopreniform disorder

Back 8

1. (2 out of 5) mixture of positive and negative symptoms that are present for a significant portion of time during a 1-6 month period

2. decline in social and occupational functioning not required

3. symptoms not better accounted by schizophrenia or mood disorder with psychotic features

4. symptoms not accounted by another medical condition, substance that is etiologically related to the development of symptoms

5. can be diagnosed in addition to a neurodevelopmental disorder

Front 9

Brief Psychotic Disorder

Back 9

1. One out of 4 symptoms for at least 1 day but less than 1 month

a. one of the symptoms must be either delusions, hallucinations, or disorganized speech

b. negative symptoms not present

2. Temporary decline in functioning followed by full remission of symptoms

Front 10

Delusional Disorder

Back 10

1. at least 1 month of one or more delusions

2. no other psychotic symptoms are present

3. criteria for schizophrenia never met

4. functioning is not markedly impaired and behavior is not bizarre or odd

5. specify type:

a. persecutory

b. grandiose

c. jealous

d. erotomanic

e. somatic

f. mixed

g. unspecified

Front 11

Schizoaffective Disorder

Back 11

1. active phase symptoms of schizophrenia and mood episode (depression or mania) occur together. Time frame is 1 month for active phase psychosis, 2 weeks for major depressive episode, and 1 week for mania

2. Phase of mixed psychotic and mood symptoms is preceded or followed by at least 2 weeks of delusions or hallucinations without mood symptoms

3. there may one one or more mood episodes during course of the illness

4. mood episodes must be present for the majority of the total duration of the illness

Front 12

Substance/Medication-induced Psychotic Disorder

Back 12

1. presence of hallucinations and/or delusions

2. symptoms are direct consequence of:

a. drug of abuse

b. medication

c. toxin exposure

2. causes significant distress or impairment

3. specify if:

a. onset during intoxication

b. onset during withdrawal

Front 13

Psychotic Disorder Due to Another Medical Condition (AMC)

293.81 (F06.2) with delusions

293.82 (F06.0) with hallucinations

Back 13

1. prominent hallucinations and/or delusions

2. evidence that symptoms are the direct consequence of another medical condition

3. not better accounted for another mental disorder

4. causes significant distress or impairment

5. in the diagnostic impression section of your report list the other medical condition first, then list the name of the other medical condition in the name of the mental disorder

Front 14

Catatonia

Back 14

Can occur in context of several disorders (psychotic, depressive, neurodevelopmental, depressive, other medical conditions

Presence of at least 3 out of 12 psychomotor disturbances:

-stupor

-cataplexy (passive induction of posture held against gravity)

-waxy flexibility (slight even resistance to positioning)

-mutism (no or very little response to attempts at conversation)

-negativism (opposition or no response to attempts at conversation)

-posturing (spontaneous and active maintenance of a posture against gravity)

-mannerism (Odd, circumstantial caricature of normal actions)

- stereotypy (repetitive, abnormally frequent, non-goal-directed movements

-agitation (not influenced by external stimuli)

grimacing (sharp contortion of the face)

-ecolalia (mimicking another person's speech)

-echopraxia (mimicking another person's movement)

(8) Catatonia associated with another mental disorder

(9) Catatonic disorder due to another medical condition

(10) unspecified catatonia

(11) Other specified schizophrenia spectrum and other psychotic disorder

(12) unspecified schizophrenia spectrum and other psychotic disorder