Schizophrenia and other psychotic disorders are actually a wide spectrum of diagnoses. This section starts with all the
Schizophrenia spectrum ones (hint, if it starts with schizo- it's on the schizophrenia spectrum) and then goes on to the
psychosis spectrum ones. All of these however are considered psychotic disorders (aside from SzPD.)
Schizophrenia [Sz] is a disorder with continuous, relapsing episodes of psychosis. When talking about schizophrenia, there are
positive symptoms, which are things that are there that others don't experience (psychotic symptoms are in this category
among other things like paranoia), there are negative symptoms, which are things that everybody else experiences that those
with schizophrenia don't, and there are cognitive symptoms which interrupt thinking ability. The disturbance of the disorder
must last at least 6 months, with 1 month of "active" psychotic symptoms, a "prodrome" (before) phase and a "residual" (after)
phase that consists of mainly negative symptoms.
Schizoaffective Disorder [Sza] is where somebody experiences both Schizophrenia and a mood disorder - bipolar or
depression. It is essentially a comorbidity.
Schizo-Obsessive Disorder is where somebody experiences both Schizophrenia and Obsessive-Compulsive Disorder, or OCD.
Schizo-Obsessive has not been put in either the DSM or ICD as of yet, but it has been highly researched, with 25% of people
with Schizophrenia having OCD symptoms and 12% having full-blown OCD.
Schizophreniform Disorder is defined by an episode of Schizophrenia that lasts between 1 - 6 months (or, too short for a Schizophrenia diagnosis.)
Schizotypal (Personality) Disorder [St(P)D] is considered both a schizo-spectrum disorder and a personality disorder. It's
typically thought of as "less intense" schizophrenia, with some of its symptoms being bodily illusions, magical thinking, or
ideations. However, it's more faithful to recognize that isolation from peers due to social anxiety and paranoid
ideation/suspiciousness is a large part of this disorder. Schizotypy is more of a continuum of personality traits than a distinct
state like psychosis is. Someone with StPD would have constant schizotypy, as it's a personality thing, rather than how
psychosis in Schizophrenia happens in episodes. Schizotypal is not considered a personality disorder in the ICD-11 while in the
DSM-5 it is, but their criteria is almost the same.
Schizoid Personality Disorder [SzPD/ScPD] is typically defined by negative symptoms - emotional coldness, flat affect,
anhedonia, etc - in the absense of positive symptoms. SzPD is about a lack of desire for close relationships, and is
characterized by a dilemma between engulfment in relationships and isolation from peers. People with SzPD often experience
an aversion to self-disclosure and emotional intimacy and the expectations brought on by such things. People with SzPD may
appear sociable on the outside as a part of a persona/mask ('covert' schizoids.)
A personality disorder that includes self-image issues, chronic feelings of emptiness, difficulty managing emotions and behavior,
impulsivity, frequent mood swings, constantly relapsing self-harm or suicidality, and a pattern of instability in relationships.
Most central to BPD is the fear of abandonment and a difficulty tolerating being alone, and the extreme measures or attempts to
avoid this abandonment, real or imagined. Under stress, people with BPD can experience psychosis.
Delusional Disorder is defined by delusion. It can consist of one delusion or many - often related. It lasts at least 3 months and
typically much longer, and there is no Depression, Mania, or mixed episodes. Other symptoms of psychosis and Schizophrenia
like hallucinations, disorganized thinking, or negative symptoms are not there, but there may be hallucinations and illusions that
are related to the delusion.
Brief Psychotic Disorder is a psychotic episode lasting a day to a month, having a sudden onset and often causing emotional turmoil.
This is psychosis due to substance use or withdrawal from a substance. There are many substances that can cause this,
including alcohol, amphetamines, cannabis, cocaine, hallucinogens, opioids, phencyclidine (PCP), and sedative/hypnotics.
Antipsychotics withdrawal is known to cause rebound psychosis as well.
This is when psychosis is caused by a temporary or chronic illness. People with a genetic disposition to psychosis are more likely
to experience psychosis along with another illness. This does not include delirium. There are a wide variety of physical illnesses
that can cause psychosis, including brain tumors, traumatic brain injury, epilepsy, autoimmune disorders, thyroid disease,
Huntington’s disease, central nervous system infections, cerebrovascular disease, auditory or visual nerve damage, multiple
sclerosis, stroke, or a migraine headache.
This is for when symptoms appear that are characteristic of psychosis, but do not fit other diagnostic criteria. There are four categories in the DSM-5:
This is basically "other specified" where none of the other diagnostic criteria are met, but the clinician chooses not to specify
the reason, including situations where there may not be enough time to make a more specific diagnosis like emergency room settings.