Psychotic Disorders

What Are Psychotic Disorders?

Psychotic disorders are a group of mental health conditions that impact how the affected person thinks, perceives reality, and interacts with the world around them.

Delusions are false beliefs that persist despite evidence to the contrary. These false beliefs often go against religious or cultural norms. Hallucinations, on the other hand, occur when someone senses something that is not real. People who hallucinate may see, taste, feel, hear, or smell something that seems real to them but only exists in their imagination.

In addition to hallucinations and delusions, people who have psychotic disorders may have disorganized thinking, which can make it difficult for them to express their emotions and can make it challenging to function in daily life.

Types of Psychotic Disorders

Several types of psychotic disorders vary in causes, symptoms, and the course of the condition. Understanding the differences in these main types can help clarify how these conditions present and how they affect people who have them.

Schizophrenia

Schizophrenia is one of the more well-known psychotic disorders and affects around 1% of the worldwide population.

Schizophrenia is usually characterized by delusions, hallucinations, and disorganized thinking and speech. People with schizophrenia often have unusual physical behaviors as well.

Symptoms of schizophrenia include:

• Delusions
• Hallucinations
• Beliefs that the mind is being controlled or read by others
• Difficulty speaking or expressing emotions
• Abnormal behaviors such as repetitive actions  
• Inability to function in normal life, such as a lack of emotion or attention to self-care and hygiene
• Disorganized or pressured speech, including scattered speech

Schizophrenia is a lifelong condition that typically requires medical treatment.

Schizophreniform Disorder

Schizophreniform disorder has the same symptoms as schizophrenia but differs in the length of time that those symptoms last. The symptoms of schizophreniform disorder last for more than one month but less than six months.

Schizophreniform disorders have to have at least two of the symptoms of schizophrenia, including:

• Delusions
• Hallucinations
• Disorganized thoughts or speech
• Disorganized behavior
• Negative symptoms

If someone has these symptoms for more than a month, schizophreniform disorder may be considered, but if the symptoms last for more than six months, then schizophrenia is more likely.

Schizoaffective Disorder

Schizoaffective disorder also shares the symptoms of schizophrenia. With schizoaffective disorder, there are symptoms of mood disorders, such as bipolar disorder or depression, associated with psychotic disorder symptoms.

Schizoaffective disorder is less common than schizophrenia, occurring in around 0.3% of people. People with this condition are often mistakenly diagnosed with either schizophrenia or bipolar disorder because of the overlap between the conditions.

Delusional Disorder

Delusional disorders involve one or more delusions that last for at least a month. These delusions are usually non-bizarre. This means that the delusions are situations that are not impossible but are also not real. Several types of delusions are more commonly seen with delusional disorder.

• Delusions of persecution: Delusions that people are conspiring against them, harassing them, or attacking them and blocking them from achieving long-term goals
• Jealous delusions: Thoughts that their sexual partner is not faithful
• Bizarre delusions: Delusions that are impossible and not related to normal life
• Delusions of grandeur: Believing that one has great talent, inflated self-worth, power, intelligence, or believing that they are in a relationship with someone famous
• Erotic delusions: Believing that someone (usually someone of higher social status) is in love with them
• Thought broadcasting: Delusions that others can read their thoughts
• Thought insertion: Believing that someone else is putting thoughts into their head

People with delusional disorder may experience one type of delusion, or the delusions may be mixed. This disorder usually starts at a later age than other psychotic disorders.

Brief Psychotic Disorder

Brief psychotic disorder shares symptoms with schizophrenia and its related disorders. However, with brief psychotic disorder, the symptoms resolve within a month.

Brief psychotic disorder is usually characterized by an event that triggers the symptoms, though it can occur without a trigger. Classifications for brief psychotic disorder include:

• Brief psychotic disorder with marked stressors: Psychotic symptoms in response to an event that would cause stress for anyone of the same culture
• Brief psychotic disorder without marked stressors: Psychotic symptoms without an event that would cause stress for people of the same culture
• Postpartum brief psychotic disorder: Psychotic symptoms starting within four weeks of having a baby

It can be hard to diagnose brief psychotic disorder when the symptoms first show up because the diagnosis is largely dependent on how long the symptoms last.

Psychotic Disorder Symptoms

Many of the psychotic disorders share similar symptoms. The symptoms can vary in their severity and how they present. How long the symptoms last often determines which type of psychotic disorder is present.

Hallucinations are one of the primary symptoms associated with psychotic disorders. Hallucinations involve seeing, hearing, feeling, tasting, or smelling things that aren’t really there. Hearing voices is one of the most common types of hallucinations people experience.

Delusions are another core symptom of psychotic disorders. These involve strong beliefs that are not based in reality, even when evidence that contradicts these beliefs is present.

People with psychotic disorders often have difficulty organizing their thoughts and often jump around between unrelated topics. They may also use words in unusual ways.

Signs Someone is Experiencing Psychosis

Recognizing when someone you love is experiencing psychosis is challenging, but it provides important opportunities for support and treatment. Common signs that someone may be in psychosis include:

• Withdrawal from family or friends
• Loss of interest in activities they used to enjoy
• Neglecting personal hygiene
• Jumping from topic to topic
• Using words or phrases out of context
• Flat, inappropriate, or exaggerated emotions

Another sign that someone is in psychosis involves intense suspicion or fear without a clear reason for those symptoms. They may express strong beliefs that seem out of touch with reality. They may also have difficulty concentrating or organizing their thoughts and may become agitated.

What Causes Psychotic Disorders?

The causes of psychotic disorders are not well understood. It’s believed that genetics, biology, and environmental factors all play a role in psychotic disorders. Causes can include:

• Having a family member with schizophrenia or another psychotic disorder may increase the risk of developing one.
• There may also be an association with neurologic diseases or brain injuries.
• The environment also plays a role, and people who have had significant traumatic experiences or who have a substance use disorder may also be at an increased risk for psychotic disorders.
• Psychotic disorders may also appear in times of extreme stress or sleep deprivation.

What Is AI-Induced Psychosis?

AI-induced psychosis is an emerging form of psychosis that is triggered or worsened by interaction with artificial intelligence.

As conversations around AI companions and mental health continue to grow, it is important to recognize that these AI companions can have both positive and negative effects on mental health. Often, people who experience AI-induced psychosis have underlying mental health conditions, and the interactions with these AI-based platforms can increase confusion, delusions, or paranoia. Exposure to AI platforms may induce psychosis by blurring the boundaries between reality and the digital world.

Treatment for Psychotic Disorders

Treatment for psychotic disorders often requires a comprehensive approach including medication and psychotherapy. Treatment should address both immediate symptoms and long-term stability and recovery.

The most common medications used to treat psychotic disorders are antipsychotic medications. These medications decrease hallucinations and delusions and help with organizing thinking. Antipsychotic medications are often used in combination with therapies such as cognitive-behavioral therapy.

People who have schizophrenia or another psychotic disorder may also benefit from support services such as vocational training, social skills training, or even case management to help the individual maintain independence.

Ongoing monitoring and collaboration between the healthcare team, the patient, the family, and support services help ensure that people who have psychotic disorders can have the most fulfilling life possible.