Level of consciousness and awareness are usually—but not always—intact. Overall appearance may be normal, or disheveled and unkempt. DSM-5 , diagnostic criteria for schizophrenia include symptoms persisting for at least six months and significant difficulty in one or more major functional capacities. In the manic phase of bipolar I disorder, the patient may present with at least a seven-day history of elevated or expansive mood, hallucinations or delusions, extreme goal-directed activity, and decreased need for sleep.
With psychotic depression, a patient is likely to have decreased energy and delusions or hallucinations consistent with major depression, such as voices reinforcing the patient's feeling of guilt or worthlessness.
Alternatively, patients with major depressive disorder may present with prominent symptoms of anxiety or even panic. Patients experiencing a brief psychotic episode display the cardinal symptoms of delusions, hallucinations, and disorganized speech, but for a shorter period of time and with eventual recovery.
Postpartum psychosis is classified in DSM-5 as a brief psychotic disorder if it occurs during pregnancy or within four weeks after delivery. During a peripartum episode of psychosis, women have delusions, hallucinations, or disorganized speech, and may have hallucinations telling them to hurt or kill their baby.
In secondary psychosis, there may be cognitive difficulties, abnormal vital signs, and visual hallucinations. Several medical conditions may initially present with psychosis; thus, a systematic approach to diagnosis is required to identify the cause Table 2. Bruising, glucose intolerance, hyperlipidemia, hypertension, moon facies, truncal obesity.
Pituitary adenoma Cushing disease. Steroid-producing tumors. Diabetes mellitus type 1 or 2. Abnormal glucose metabolism, blurry vision, fatigue; hyper- or hypoglycemia may present with psychotic symptoms. Parathyroid disease Abdominal discomfort, bone disorders, confusion, depression, fatigue, hallucinations, kidney stones, paranoia.
Huntington disease Schizophrenia-like symptoms may occur before cognitive or extrapyramidal changes. Lewy body disease Executive dysfunction, fluctuating awareness, Parkinsonian motor symptoms, visual hallucinations.
Neuroleptic drugs may cause sudden death or worsen movement, and should be avoided. Parkinson disease often described with Lewy body disease as a continuum of symptoms 21 , Forward gait, slowing, stiffness, tremor; delusions, hallucinations, and psychotic symptoms are common in later stages.
Wilson disease Abdominal swelling, delusions, jaundice, Kayser-Fleischer rings, schizophrenia-like psychosis, tremor, vomiting.
Copper accumulation. Encephalitis 24 , Bizarre behaviors, chills, decreased sensorium, fever, headache, low sodium levels. Human immunodeficiency virus Rule out delirium; may be medication adverse effect; new onset of antiretroviral therapy can cause psychosis. Abnormal gait, cognitive deficits, headache, incontinence, seizures, visual disturbances. CT or MRI, lumbar puncture, treponemal antibody testing e. Acute intermittent porphyria Abdominal pain, fever, peripheral neuropathy, tachycardia; may have only psychotic symptoms.
Genetic enzyme defect; fasting and drugs affecting the cytochrome P system act as inducers. Tay-Sachs disease, adult onset Dystonia, spinocerebellar signs; psychosis appears in one-third to one-half of patients. Dementia 16 , Alzheimer type. Prominent short-term memory loss; may have aggression, agitation, or paranoia; delusions may be mistaken for misperceptions because of cognitive changes.
Nutritional deficiencies 32 - Confabulation, history of alcoholism, Korsakoff psychosis, older age, Wernicke encephalopathy. Psychotic symptoms in late childhood, early adolescence; in older adults, ataxia, glossitis, cogwheel rigidity, abdominal symptoms, persecutory delusions, hallucinations.
Complete blood count, Helicobacter pylori testing, intrinsic factor antibody testing, serum folate and vitamin B 12 testing. Ovarian teratoma Anti— N -methyl- d -aspartate receptor encephalitis may be associated with teratomas. Paraneoplastic limbic encephalitis CT, MRI, or electroencephalography; lumbar puncture; anti-Hu antibody testing; consider carcinoembryonic antigen and cancer antigen testing.
Pharmacologic conditions Table 3. Acute onset, agitation, altered mental status, delusions, hypertension, tachycardia, visual hallucinations. Psychiatric conditions 5 , 11 , 16 , 37 , Mania: decreased need for sleep, elevated or irritable mood, racing thoughts, risk taking.
May present with depression; inquire about prior manic symptoms; selective serotonin reuptake inhibitors should be used with caution; lifetime prevalence of 0. Depression: anhedonia, changes in sleep and appetite, depressed mood, guilt, hopelessness, suicidality. Depression with psychotic features.
Anhedonia, changes in sleep and appetite, delusions, depressed mood, guilt, hallucinations, hopelessness, paranoia, suicidality; may present with symptoms of panic and anxiety. Clinical diagnosis of exclusion. Psychotic disorder brief. Delusions and paranoia with hallucinations lasting one day to one month; if in peri- or postpartum phases, mother may have delusions that the baby is possessed, or hallucinations telling her to harm the baby. Schizoaffective disorder. Auditory hallucinations, delusions, paranoia; overlap with schizophrenia and mood disorders; functional difficulty not a defining criterion.
Auditory hallucinations, delusions, paranoia; decline in ability to work, or maintain relationships or self-care; a prodromal phase occurs when patients report peculiar perceptual experiences. First break often in late adolescence or early adulthood; prevalence of 0. Thyroid dysfunction. Information from references 5 , 11 , 16 , and 19 through Medical conditions associated with psychosis include autoimmune, endocrine, neurologic, and nutritional disorders.
Hallmark neurologic conditions include temporal lobe epilepsy, Parkinson disease, and Lewy body disease. A subacute onset of psychosis should raise suspicion for an oncologic cause, such as a steroid-producing tumor, space-occupying brain lesion, or paraneoplastic etiology.
Genetic or heritable diseases should be considered; for example, Huntington disease may first present with a psychotic episode. Information on medication interactions and use of herbal, over-the-counter, and recreational drugs should be elicited, because drug toxicity is a common cause of acute psychotic reactions 18 , 37 Table 3 18 , 37 , Information from references 18 , 37 , and Obtaining a history from a patient with psychotic symptoms may be challenging.
Recognition of psychosis by the primary care physician is facilitated by prior knowledge of a patient's family, medical, and cultural history. Individual cultures reflect a set of beliefs, values, and practices shared by members of a particular group.
Delusional thinking and hallucinations should be considered within the patient's specific cultural context. What may appear delusional in one culture may be normal in another.
Hallucinations relating to religious expressions may be accepted in certain groups. The temporal relationship and course of psychotic symptoms, as well as the patient's age, background, and general medical condition, may provide diagnostic clues. An onset of psychosis may occur acutely after recreational drug use or as a later presentation in multiple sclerosis. Whenever possible, collateral information should be collected from family members. The social history should include recent stressors or significant changes in the patient's life, such as job loss, death of a significant other, educational stress, or other traumatic event.
Family history may provide clues to suggest a psychiatric diagnosis or heritable condition. We hear the words often, used in the media, online, and on the street. Psychosis is part of schizophrenia, and it can be part of other disorders as well. Psychosis is a concept that describes specific symptoms.
Schizophrenia is a mental illness that has psychotic features. When broken down into symptoms, the notion of schizophrenia vs psychosis makes sense. Instead, specific features define the experience we call psychosis. The psychotic symptoms include:. In psychosis, not all of these need be present. In schizophrenia, psychosis is the first criteria that must be met for a diagnosis of schizophrenia. Without psychosis, there is no schizophrenia. However, psychosis alone does not comprise schizophrenia.
To have schizophrenia, someone must also experience other symptoms:. The difference between psychosis and schizophrenia is that psychosis refers to symptoms and can be part of many things. Schizophrenia is a serious mental illness that includes the symptoms of psychosis. Table of Contents View All. Table of Contents. Can Psychosis Go Away? Schizophrenia Is Not "Split Personalities" Though a common misconception, people with schizophrenia do not have "split personalities.
Consult Your Healthcare Provider Never stop taking an antipsychotic medication without consulting your healthcare provider. Was this page helpful?
Thanks for your feedback! Sign Up. What are your concerns? Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Related Articles. What Is the Schizophrenia Spectrum? What Is Psychotic Depression? How Is Childhood Schizophrenia Treated?
What Causes Psychosis? When Do Schizophrenia Symptoms Start? What Is Psychosis? Signs and Treatment of Schizophrenia With Paranoia. Postpartum Psychosis: Causes, Symptoms, and Treatment. Signs and Symptoms of Paranoid Schizophrenia. What Is Schizophreniform Disorder? Anosognosia: Definition, Symptoms, Causes, Treatment. What Is a Schizophrenia Test? But the sooner you start treatment and the longer you sustain treatment, the better. Family caregivers should also to seek help and training for themselves — so they can better to support the patient, understand the condition in question, and maintain self-care.
If anyone would like to add to this topic and contact us to find out more, feel free to fill out the form below. Part 1. Previous Next. Psychosis vs Schizophrenia: What is the Difference?
Schizophrenia: understanding the distinction between the 2 What is the Difference Between Psychosis and Schizophrenia? What is Schizophrenia? There are also different types of schizophrenia: Schizoaffective disorders: Includes symptoms of both schizophrenia and a mood disorder such as depression or bipolar disorder Schizophreniform disorders: Includes symptoms of schizophrenia, but the symptoms last for a shorter time, between 1 and 6 months.
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